{"id":898,"date":"2013-05-29T10:28:54","date_gmt":"2013-05-29T08:28:54","guid":{"rendered":"http:\/\/slanedeti.sk\/cms\/cysticka-fibroza-reprodukcne-zdravie-a-sexualita-2\/201305"},"modified":"2014-01-01T11:54:00","modified_gmt":"2014-01-01T10:54:00","slug":"cysticka-fibroza-reprodukcne-zdravie-a-sexualita-2","status":"publish","type":"post","link":"https:\/\/slanedeti.sk\/cms\/cysticka-fibroza-reprodukcne-zdravie-a-sexualita-2\/898","title":{"rendered":"Cystick\u00e1 fibr\u00f3za, reproduk\u010dn\u00e9 zdravie a sexualita"},"content":{"rendered":"

V posledn\u00fdch desa\u0165ro\u010diach pri\u0161lo k zv\u00fd\u0161eniu priemern\u00e9ho veku do\u017eitia CF pacientov a n\u00e1sledkom toho aj k zv\u00e4\u010d\u0161eniu ich dospelej popul\u00e1cie. Preto sa aj vyn\u00e1raj\u00fa nov\u00e9 t\u00e9my, s\u00favisiace so \u017eivotom a starostlivos\u0165ou o dospel\u00fdch pacientov, ktor\u00e9 nemali predt\u00fdm a\u017e tak\u00fd v\u00fdznam. Zd\u00e1 sa, \u017ee aj vzh\u013eadom na to, \u017ee sa jedn\u00e1 sk\u00f4r o nov\u00fa t\u00e9mu, niektor\u00ed pacienti nemaj\u00fa dostato\u010dn\u00e9 inform\u00e1cie ako CF ovplyv\u0148uje reproduk\u010dn\u00e9 zdravie a sexualitu. Cie\u013eom tohto \u010dl\u00e1nku je k tejto t\u00e9me zhrnutie najd\u00f4le\u017eitej\u0161\u00edch bodov a z\u00e1kladn\u00fdch inform\u00e1cii.<\/p>\n

N\u00e1stup puberty<\/strong><\/h4>\n

U det\u00ed s CF nastupuje puberta v priemere o dva roky nesk\u00f4r. Zd\u00e1 sa \u017ee n\u00e1stup puberty ovplyv\u0148uj\u00fa aj \u010fal\u0161ie faktory \u0161pecifick\u00e9 pre CF, pri\u010dom d\u00f4le\u017eit\u00fd je stav v\u00fd\u017eivy. Jedinci, ktor\u00ed maj\u00fa bli\u017e\u0161ie k prejavom malnutr\u00edcie (probl\u00e9m s celkov\u00fdm stavom v\u00fd\u017eivy \u2013 sp\u00f4soben\u00fd pri CF najm\u00e4 zn\u00ed\u017eenou funkciou pankreasu) maj\u00fa vo v\u0161eobecnosti aj neskor\u0161\u00ed n\u00e1stup puberty.<\/p>\n

\"dvaja\"<\/div>\n

Reproduk\u010dn\u00e9 zdravie u mu\u017eov<\/strong><\/h4>\n

Takmer v\u0161etci (98 %) mu\u017ei s CF s\u00fa neplodn\u00ed. Pri CF nie je ovplyvnen\u00e1 tvorba spermii, ale CF je pr\u00ed\u010dinou v\u00fdvojovej poruchy vas deferens, n\u00e1sledkom ktorej nem\u00f4\u017eu by\u0165 spermie transportovan\u00e9 zo semenn\u00edkov. Ejakul\u00e1t preto neobsahuje spermie (azospermia). \u010eal\u0161\u00edm prejavom CF u mu\u017eov v rozmno\u017eovacom trakte je atrofia semenn\u00fdch va\u010dkov, n\u00e1sledkom \u010doho je objem ejakul\u00e1tu v\u00fdrazne zn\u00ed\u017een\u00fd. Z t\u00fdchto d\u00f4sledkov ale nevypl\u00fdvaj\u00fa obmedzenia pre sexu\u00e1lne aktivity alebo vz\u0165ahy. Nov\u00e9 met\u00f3dy asistovanej reprodukcie prin\u00e1\u0161aj\u00fa pre mu\u017eov s CF mo\u017enos\u0165 ma\u0165 biologick\u00fdch potomkov. Jedn\u00e1 sa o kombin\u00e1ciu MESA (microsurgical epididymal sperm aspiration) a in-vitro fertiliz\u00e1cie (IVF) resp. ICSI (intracytoplasmatic sperm injection). Tieto met\u00f3dy s\u00fa technicky aj finan\u010dne n\u00e1ro\u010dn\u00e9 a nie dostato\u010dne \u00faspe\u0161n\u00e9, preto nie s\u00fa be\u017ene pou\u017e\u00edvan\u00e9.<\/p>\n

Reproduk\u010dn\u00e9 zdravie u \u017eien<\/strong><\/h4>\n

<\/strong>CF mnoh\u00fdmi sp\u00f4sobmi ovplyv\u0148uje rozmno\u017eovac\u00ed trakt u \u017eien, vo v\u0161eobecnosti je ale plodnos\u0165 u v\u00e4\u010d\u0161iny \u017eien s CF zachovan\u00e1. Predpoklad\u00e1 sa, \u017ee CF m\u00e1 vplyv na vylu\u010dovanie niektor\u00fdch \u017eensk\u00fdch pohlavn\u00fdch horm\u00f3nov (napr. gon\u00e1dotrop\u00edn uvo\u013e\u0148uj\u00faceho horm\u00f3nu). Tento vplyv na vylu\u010dovanie horm\u00f3nov je t\u00e9mou st\u00e1le prebiehaj\u00faceho a zatia\u013e neuzavret\u00e9ho v\u00fdskumu. Prinajmen\u0161om u \u010dasti \u017eien CF zapr\u00ed\u010di\u0148uje zn\u00ed\u017eenie plodnosti, t.j. mo\u017enosti otehotnie\u0165 alebo neplodnos\u0165. Pr\u00ed\u010dinou je najm\u00e4 hust\u00e1 konzistencia cervik\u00e1lneho hlienu, ktor\u00fd potom predstavuje bari\u00e9ru pre spermie a oplodnenie. V\u00fdznam maj\u00fa v\u0161ak aj \u010fal\u0161ie faktory ako stav v\u00fd\u017eivy, chronick\u00fd z\u00e1pal. Taktie\u017e sekund\u00e1rnym d\u00f4sledkom lie\u010dby m\u00f4\u017eu by\u0165 mykotick\u00e9 infekcie po\u0161vy, alebo dlhodob\u00e1 lie\u010dba steroidmi m\u00f4\u017ee nar\u00fa\u0161a\u0165 ovula\u010dn\u00e9 cykly. V minulosti sa uv\u00e1dzalo \u017ee okolo 40 % \u017eien s CF je neplodn\u00fdch. V s\u00fa\u010dastnosti je v\u0161ak zrejm\u00e9, \u017ee ovplyvnenie plodnosti je ni\u017e\u0161ie, \u010do m\u00f4\u017ee by\u0165 aj d\u00f4sledkom zlep\u0161uj\u00facej sa lie\u010dby, urobi\u0165 ale presn\u00fd odhad je problematick\u00e9. Oh\u013eadom antikoncepcie nie s\u00fa pri CF \u0161pecifick\u00e9 obmedzenia, je ale potrebn\u00e9 pam\u00e4ta\u0165 na to, \u017ee probl\u00e9my v tr\u00e1viacom trakte ktor\u00e9 s\u00fa \u010dast\u00e9 pri CF (z\u00e1pchy, hna\u010dky, vracanie, zn\u00ed\u017eenie vstreb\u00e1vanie) m\u00f4\u017eu ovplyvni\u0165 \u00fa\u010dinnos\u0165 peror\u00e1lnej antikoncepcie.<\/p>\n

Tehotenstvo<\/strong><\/h4>\n

<\/strong>Z\u00e1mer otehotnie\u0165 sa rozhodne odpor\u00fa\u010da vopred prediskutova\u0165 s lek\u00e1rom \u0161pecializovan\u00fdm na CF. Tehotenstvo sa neodpor\u00fa\u010da pacientk\u00e1m, ktor\u00e9 nesp\u013a\u0148aj\u00fa niektor\u00e9 zdravotn\u00e9 krit\u00e9ri\u00e1, vz\u0165ahuj\u00face sa ku stavu v\u00fd\u017eivy a p\u013e\u00facnym funkci\u00e1m. Pri dodr\u017ean\u00ed stanoven\u00fdch z\u00e1sad sa tehotenstvo s CF pova\u017euje za zvl\u00e1dnute\u013en\u00e9 a neprin\u00e1\u0161a matke ani die\u0165a\u0165u z\u00e1sadn\u00e9 rizik\u00e1.\u00a0 V\u00fdskum \u010di m\u00f4\u017ee ma\u0165 tehotenstvo vplyv na \u010fal\u0161\u00ed priebeh ochorenia st\u00e1le prebieha, ale v s\u00fa\u010dastnosti v\u00e4\u010d\u0161ina lek\u00e1rov nepova\u017euje tehotenstvo za riziko pre \u010fal\u0161\u00ed priebeh CF.<\/p>\n

Psycho-soci\u00e1lne aspekty<\/strong><\/h4>\n

<\/strong>Na z\u00e1klade v\u00fdskumov bolo identifikovan\u00fdch nieko\u013eko oblast\u00ed s\u00favisiacich s CF a sexualitou, ktor\u00e9 si zasluhuj\u00fa pozornos\u0165.
\nJedn\u00fdm z probl\u00e9mov je informovanos\u0165 pacientov, ktor\u00e1 sa zd\u00e1 by\u0165 nedostato\u010dn\u00e1. Najspo\u013eahlivej\u0161\u00edm zdrojom inform\u00e1cii o ot\u00e1zkach ako ochorenie ovplyv\u0148uje reproduk\u010dn\u00e9 zdravie a sexualitu je odborn\u00fd lek\u00e1r. Pre lek\u00e1ra je pochopite\u013ene prioritou klinick\u00fd stav a v kombin\u00e1cii s \u010fal\u0161\u00edmi okolnos\u0165ami ako hanblivos\u0165 niektor\u00fdch pacientov diskutova\u0165 o sexu\u00e1lnych t\u00e9mach alebo \u010dasto napr\u00edklad aj nedostatkom \u010dasu, s\u00fa pr\u00ed\u010dinou, \u017ee pacient alebo jeho rodina sa o \u0161pecifick\u00fdch aspektoch ochorenia niekedy nedozvedia.
\nZistilo sa, \u017ee CF pacienti \u010dastej\u0161ie ignorovali antikoncep\u010dn\u00e9 met\u00f3dy. Pr\u00ed\u010dinou bolo u \u017eien presved\u010denie o ich n\u00edzkej mo\u017enosti otehotnenia, no v\u00fdsledkom bol \u010dastej\u0161\u00ed v\u00fdskyt ne\u017eelan\u00fdch tehotenstiev. U mu\u017eov s CF vedomie neplodnosti taktie\u017e zni\u017eovalo vn\u00edmanie potreby pou\u017ei\u0165 kond\u00f3m, \u010d\u00edm sa pochopite\u013ene vystavovali zv\u00fd\u0161en\u00e9mu riziku infekcie sexu\u00e1lne prenosn\u00fdmi ochoreniami.
\nV s\u00favislosti s tehotenstvom samozrejme prich\u00e1dzaj\u00fa ot\u00e1zky s\u00favisiace so starostlivos\u0165ou o deti a v pr\u00edpade CF osobitne mo\u017enosti, \u017ee zhor\u0161uj\u00faci zdravotn\u00fd stav, pr\u00edpadne pred\u010dasn\u00e1 smr\u0165, t\u00fato starostlivos\u0165 znemo\u017en\u00ed.<\/p>\n

Rodi\u010d s CF v\u017edy pren\u00e1\u0161a na die\u0165a k\u00f3piu CF g\u00e9nu. Z toho d\u00f4vodu m\u00e1 v\u00fdznam genetick\u00e9 testovanie partnera, pr\u00edpadne genetick\u00e9 poradenstvo (v pr\u00edpade, \u017ee partner je taktie\u017e nosi\u010dom CF g\u00e9nu).<\/p>\n","protected":false},"excerpt":{"rendered":"

V posledných desaťročiach prišlo k zvýšeniu priemerného veku dožitia CF pacientov a následkom toho aj k zväčšeniu ich dospelej populácie. Preto sa aj vynárajú nové témy, súvisiace so životom a starostlivosťou o dospelých pacientov, ktoré nemali predtým až taký význam. … Continued<\/a><\/p>\n","protected":false},"author":7,"featured_media":1084,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"kt_blocks_editor_width":"","footnotes":""},"categories":[250],"tags":[212,213],"class_list":["post-898","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zivot-s-cystickou-fibrozou","tag-reprodukcne-zdravie","tag-sexualita"],"yoast_head":"\nCystick\u00e1 fibr\u00f3za, reproduk\u010dn\u00e9 zdravie a sexualita - Slan\u00e9 deti<\/title>\n<meta name=\"description\" content=\"N\u00e1sledkom zv\u00e4\u010d\u0161enia dospelej popul\u00e1cie pacientov s CF sa vyn\u00e1raj\u00fa t\u00e9my ako CF ovplyv\u0148uje reproduk\u010dn\u00e9 zdravie a sexualitu.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/slanedeti.sk\/cms\/cysticka-fibroza-reprodukcne-zdravie-a-sexualita-2\/898\" \/>\n<meta property=\"og:locale\" content=\"sk_SK\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cystick\u00e1 fibr\u00f3za, reproduk\u010dn\u00e9 zdravie a sexualita - 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