Chii chinonzi Prostate Laser Surgery? Chinangwa, Maitiro & Mhedzisiro

Prostate laser surgery inzira shoma yekuvhiya inoshandisa simba re laser rakatarisa kubvisa kana kuderedza tishu ye prostate yakakura. Iyi nzira yemazuva ano inobatsira varume vane benign prostatic hyperplasia (BPH) - mamiriro asiri ekenza apo gland ye prostate inokura yakakura uye inovhara kuyerera kweweti. Laser inonyatso tarisa tishu yakawandisa ichidzivirira nzvimbo dzakakomberedza dzine hutano, kazhinji ichikubvumira kuti uende kumba zuva rimwe chetero.

Chii chinonzi prostate laser surgery?

Prostate laser surgery inorapa prostate yakakura nekushandisa simba rechiedza chakanyanya kubvisa kana kudzikisa tishu inovhara. Chiremba wako anokutungamira fiber-optic scope yakatetepa kuburikidza ne urethra yako (tubhu inotakura weti) kuti isvike prostate pasina kuita chero kucheka kwekunze.

Laser inoshanda sechishandiso chakarurama chekucheka nekusimbisa. Inopisa tishu ye prostate yakawandisa iri kusundidzira urethra yako, ichivhura ipapo nzira yekuti weti iyerere zvakasununguka. Panguva imwecheteyo, kupisa kwe laser kunosimbisa midzi yeropa, iyo inoderedza zvakanyanya kubuda ropa zvichienzaniswa nekuvhiya kwechinyakare.

Kune mhando dzakawanda dzekuvhiya kwe laser, asi dzese dzine chinangwa chimwe chete: kugadzira nzvimbo yakawanda yeweti kuti ipfuure ichideredza kusagadzikana uye nguva yekupora. Varume vazhinji vanoona kuvandudzwa kweweti mukati memazuva panzvimbo pemavhiki.

Nei prostate laser surgery ichiitwa?

Prostate laser surgery inobatsira varume vane prostate yakakura iri kukonzera zviratidzo zvinoshungurudza zveweti zvisina kuvandudzwa nemishonga. Chiremba wako anogona kukurudzira iyi nzira kana hupenyu hwako huchikanganiswa zvakanyanya nekuwanda kweweti usiku, kuyerera kweweti kusina simba, kana kunzwa sekunge haugone kubvisa zvachose bladder yako.

Maitiro acho anodiwa kana kurapwa kwemazuva ose sekushandisa mishonga inonzi alpha-blockers kana 5-alpha reductase inhibitors asina kubatsira zvakakwana mushure memwedzi yakati wandei. Varume vazhinji vanosvika panguva iyi pavanomuka kakawanda usiku kuti vanyare, vachinzwa kukurumidza kuenda kuchimbuzi, kana kutarisana nerwizi rwakapera simba zvokuti zvinotora nguva refu kuti vapedze.

Dzimwe nguva kuvhiyiwa nelaser kunokurudzirwa kune matambudziko akakomba. Izvi zvinosanganisira kusakwanisa kunyara zvachose (kuchengetwa kwemvura), hutachiona hwegwara remvura hunodzoka, matombo ebladder anokonzerwa nekusazara, kana matambudziko eitsvo kubva kumvura yakadzoserwa.

Ndeapi maitiro ekuvhiyiwa kweprostate nelaser?

Kuvhiyiwa kweprostate nelaser kazhinji kunotora maminitsi 30 kusvika ku90 uye kunoitwa pasi peanesthesia yemusana kana yakajairika. Chiremba wako achakugadzirisa zvakanaka kumusana wako nemakumbo ako akakwidzwa zvishoma, zvakafanana nekuongororwa kwemazuva ose kweurological asi iwe wakarara zvachose.

Maitiro acho anotanga nechiremba wako achinyatsoisa scope yakatetepa, inochinjika inonzi resectoscope kuburikidza neurethra yako. Scope iyi ine kamera diki uye fiber ye laser, ichibvumira chiremba wako kuti aone chaizvo zvavari kuita pane monitor. Hapana kucheka kwekunze kunodiwa sezvo zvese zvinoitika kuburikidza nekuvhura kwako kwemvura yechisikigo.

Panguva yekurapa kwe laser, chiremba wako anonyatso gwida simba re laser kuti aende kunyama yakakura yeprostate. Iyo laser inobva yaparadzira nyama ipapo (mumaitiro akaita sePVP kana GreenLight) kana kuiita kuita zvidimbu zvinobviswa (mumaitiro akaita seHoLEP). Kupisa kubva ku laser panguva imwe chete kunovhara midzi yeropa, kuchengeta kubuda ropa kushoma.

Kana nyama inodzivisa yabviswa, chiremba wako achaisa catheter yenguva pfupi kuburikidza neurethra yako mubladder yako. Iyi chubhu yakatetepa inobatsira kuburitsa weti apo muviri wako unopora kubva mumaitiro acho, kazhinji ichigara munzvimbo kwemazuva 1-3 zvichienderana nemamiriro ako chaiwo.

Maitiro ekugadzirira kuvhiyiwa kwako kweprostate laser?

Kugadzirira kuvhiyiwa kweprostate laser kunosanganisira matanho akati wandei akakosha anobatsira kuona mhedzisiro yakanaka. Chiremba wako achatarisa mishonga yako yese iripo, kunyanya mishonga inoderedza ropa senge warfarin, aspirin, kana clopidogrel, iyo inogona kudikanwa kumiswa mazuva 5-7 vasati vavhiyiwa kuderedza njodzi yekubuda ropa.

Iwe unowanzo kuda kudzivisa kudya kana kunwa chero chinhu kwemaawa 8-12 usati waita maitiro ako. Iyi nguva yekutsanya yakakosha kuchengeteka kwako panguva yeanesthesia. Chikwata chako chekurapa chichakupa mirairo chaiyo yekuti ungamira rini kudya nekunwa zvichienderana nenguva yako yekuvhiya.

Mazuva akati wandei vasati vavhiyiwa, zvinobatsira kugadzirira imba yako yekupora. Chengeta zvipfeko zvakasununguka zvakasununguka, mvura yakawanda uye chikafu chine hutano, uye gadzirisa kuti mumwe munhu akutyairire kumba uye agare newe kwemaawa makumi maviri nemana ekutanga.

Chiremba wako anogona zvakare kukurudzira kumisa mamwe mavitamini senge vhitamini E, mafuta ehove, kana mishonga yemakwenzi inogona kukanganisa kubuda ropa. Kana iwe uchitora mishonga yemamwe mamiriro senge chirwere cheshuga kana BP yakakwira, iwe uchagamuchira mirairo chaiyo yekuti ndedzipi dzekuenderera mberi uye dzekumbomira.

Maitiro ekuverenga mhedzisiro yako yekuvhiya kweprostate laser?

Kubudirira mushure mekuvhiyiwa kweprostate laser kunoyerwa nekuti zviratidzo zvako zveweti zvinovandudzika zvakadii uye hupenyu hwako hunochinja sei. Varume vazhinji vanoona kuvandudzwa kukuru musimba rekuyerera weti mumazuva mashoma ekutanga, kunyangwe kupora kwakakwana uye mhedzisiro yakanaka inowanzoitika pamusoro pevhiki 4-6.

Chiremba wako anogona kushandisa zviyero zvine chinangwa chekutevera kufambira mberi kwako. Mibvunzo yeInternational Prostate Symptom Score (IPSS), iyo iwe ungangodaro wakapedzisa usati wavhiyiwa, ichadzokororwa panguva yekutevera kushanya kuti uverenge kuvandudzwa kwako. Zvikoro zvinowanzo kudonha kubva kumhando dzakakomba (20-35) kuenda kumhando dzakapfava (0-7) mushure mekuvhiyiwa kwakabudirira.

Zvidzidzo zve kuyerera kwemvura yeweti zvinopa imwe nzira yekuyera kubudirira. Pamberi pekuvhiyiwa, kuyerera kwako kwepamusoro kungave kwakanga kuri 8-10 mL pasekondi, ichionekwa seyakanyanya kunonoka. Mushure me kupora, varume vazhinji vanowana kuyerera kwe 15-20 mL pasekondi kana kupfuura, vachimiririra kuvandudzwa kukuru mukupukuta dumbu.

Zviyero zve post-void residual zvinoratidza kuti unopukuta dumbu rako zvakadii. Pre-surgery residuals ye 100-200 mL (kana kupfuura) kazhinji inodonha kusvika pasi pe 50 mL mushure mekuvhiyiwa kwelaser kunobudirira, zvichiratidza kuti dumbu rako riri kushanda zvakanyanya.

Nzira yekuvandudza kupora kwako mushure mekuvhiyiwa kweprostate laser?

Kupora mushure mekuvhiyiwa kweprostate laser kunotarisa pakubvumira muviri wako kupora uchidzokera zvishoma nezvishoma kuzviitiko zvenguva dzose. Mumazuva mashoma ekutanga, ungangonzwa kupisa zvishoma panguva yekuyera uye unogona kuona ropa rishoma mumvura yako - zvese zviri zvikamu zvakajairika zvekupora.

Kugara uine mvura yakawanda kwakakosha pakupora kwako. Kunwa mvura yakawanda kunobatsira kugeza sisitimu yako uye kunoderedza njodzi yeropa kana hutachiona. Chinangwa che 8-10 magirazi emvura zuva rega rega kunze kwekunge chiremba wako achikurudzira zvimwe, uye dzivisa doro uye caffeine iyo inogona kutsamwisa matishu ako ekupora.

Kushanda kwemuviri kunofanirwa kuwedzerwa zvishoma nezvishoma kwemavhiki akati wandei. Kufamba zvishoma kunokurudzirwa kubva pazuva rekutanga, asi unofanirwa kudzivisa kusimudza zvinhu zvinorema (kupfuura mapaundi gumi), kurovedza muviri zvakanyanya, kana zvepabonde kwemavhiki 4-6. Zvipingamupinyi izvi zvinobatsira kudzivirira kubuda ropa uye kuona kupora kwakakodzera kwenzvimbo yekuvhiya.

Varume vazhinji vanogona kudzokera kubasa remudesk mukati memazuva mashoma, nepo avo vane mabasa anoda simba remuviri vangangoda 2-3 vhiki. Chiremba wako achapa gwara rakatarwa zvichienderana nekufambira mberi kwako kupora uye zvinodiwa nebasa.

Chii chinonyanya kubuda mukuvhiyiwa kweprostate laser?

Mhedzisiro yakanaka kubva pakuvhiyiwa prostate laser ndeyekuvandudzwa kukuru, kunogara kwenguva refu mukurwadziwa kwako kwemvura yeweti nemhedzisiro shoma. Varume vazhinji vanowana kudzikiswa kukuru mukuyerera kweweti usiku, kuyerera kweweti kwakasimba, uye kugona kubvisa zvachose dumbu ravo pasina kunetsa.

Maitiro ekubudirira anokurudzira, ne85-90% yevarume vanoshuma kuvandudzwa kukuru mukurwadziwa kwavo. Vazhinji vanowana kuti vanogona kurara husiku zvakare, vasingacharonge zviitiko zvakapoteredza nzvimbo dzekugezera, uye vachinzwa vakavimbika pamusoro pekudzora kwavo dumbu panguva yezviitiko zvemazuva ese.

Mhedzisiro yakanaka inosanganisirawo kuchengetedzwa kwebasa rebonde. Nepo vamwe varume vangasangana nekuchinja kwenguva pfupi mukubuda kwemvura (semuenzaniso retrograde ejaculation uko mbeu inoenda kumashure mudumbu), basa reerectile rinowanzoita risina kuchinjwa. Varume vazhinji vanochengetedza kugona kwavo kuva neukama hunogutsa.

Kugara kwenguva refu ndechimwe chimiro chekubudirira kwekuvhiyiwa laser. Kusiyana nemimwe mishonga inogona kurasikirwa nekushanda nekufamba kwenguva, kubviswa kwemuviri kwenyama inodzivirira kunopa zororo rinogara kwenguva refu kune varume vazhinji, nekugadzirisa kurwadziwa kunochengetwa kwemakore mazhinji.

Ndezvipi zvinhu zvine njodzi zvematambudziko mushure mekuvhiyiwa prostate laser?

Zvimwe zvinhu zvinogona kuwedzera njodzi yako yematambudziko mushure mekuvhiyiwa prostate laser, kunyangwe matambudziko akakomba achiramba asingawanzoitiki. Zera rinoita basa, nevarume vanopfuura makore 75 vaine njodzi yakakwira zvishoma yekuchengetwa kwemvura yeweti kana matambudziko ekupora, kunyangwe varume vakawanda vakuru vachiri kuita zvakanaka nekuchengetwa kwakakodzera.

Mamiriro ezvinhu ekutanga ekurapa anogona kukanganisa kupora kwako. Chirwere cheshuga chinogona kunonotsa kupora uye kuwedzera njodzi yekutapukirwa, nepo mamiriro emoyo angave akaoma anesthesia. Zvirwere zvekugwamba kweropa kana mishonga inokanganisa kubuda ropa inogona kuwedzera njodzi yekubuda ropa mushure mekuvhiyiwa, kunyangwe timu yako yekuvhiya ichanyatso manejera izvi zvinhu.

Kukura uye kuoma kweprostate yako yakakura kunokanganisawo njodzi. Maprostate makuru kwazvo (anopfuura 80-100 magiramu) anogona kuda nguva refu yekuvhiyiwa uye ane mikana yakakura yekuda mamwe maitiro, kunyangwe kuvhiyiwa nelaser kuchiri kubudirira kazhinji mumamiriro ezvinhu aya.

Zvimwe zvinhu zvehupenyu zvinogona kukanganisa kupora kwako. Kusvuta kunokanganisa zvakanyanya kupora uye kunowedzera njodzi yekutapukirwa, nepo kuva uremu hwakanyanya kunogona kuomesa anesthesia nekupora. Chiremba wako achashanda newe kuti uwedzere zvinhu izvi pamberi pekuvhiyiwa chero zvichibvira.

Zviri nani kuva nekuvhiyiwa nelaser here kana kuvhiyiwa kweprostate yechinyakare?

Kuvhiyiwa nelaser kunopa zvakawanda zvakanakira pamusoro pekuvhiyiwa kweprostate yechinyakare, kunyanya kune varume vanoda kuderedza nguva yekupora nenjodzi dzekuvhiya. Nzira ye laser inowanzoita kuti kubuda ropa kushoma, kugara muchipatara kwenguva pfupi, uye kukurumidza kudzokera kumabasa akajairika zvichienzaniswa nenzira dzechinyakare senge TURP (transurethral resection ye prostate).

Kurasikirwa neropa kunoderedzwa zvakanyanya nekuvhiyiwa nelaser nekuti simba re laser rinovhara midzi yeropa sezvarinoshanda. Izvi zvinoreva kuti varume vashoma vanoda kuwedzerwa ropa, uye avo vanotora zvinoderedza ropa vanogona kukwanisa kuenderera mberi nemishonga yavo nekuchenjerera, nepo kuvhiyiwa kwechinyakare kazhinji kuchida kumisa mishonga iyi.

Nguva yekupora inowanzo pfupi nemaitiro e laser. Nepo kuvhiyiwa kwechinyakare kungangoda mazuva 3-5 muchipatara, varwere vazhinji vekuvhiyiwa nelaser vanoenda kumba zuva rimwe chete kana mushure mehusiku humwe. Iyo catheter inowanzo bviswa nekukurumidza, kazhinji mukati me1-2 mazuva panzvimbo pe3-5 mazuva.

Zvisinei, kuvhiyiwa kwechinyakare kunogona kuramba kuchikurudzirwa mune dzimwe nzvimbo. Maprostate makuru kwazvo, ayo ane mavanga akakosha, kana nyaya dzine cancer inofungidzirwa inogona kubatwa zviri nani nenzira dzechinyakare. Urologist wako achakurudzira sarudzo yakanakisa zvichienderana neanatomy yako chaiyo uye mamiriro ekurapa.

Ndezvipi zvingaitika mushure mekuvhiyiwa kwe prostate neraser?

Kunyange zvazvo kuvhiyiwa kwe prostate neraser kuchiwanzova kwakachengeteka, kunzwisisa zvingaitika kunokubatsira kuti uite zvisarudzo zvine ruzivo uye kuziva nguva yekutsvaga rubatsiro rwekurapa. Zvizhinji zvezvinhu zvinogona kuitika zvidiki uye zvenguva pfupi, asi zvakakosha kuziva zvingaitika.

Zvinowanzoitika munguva pfupi zvinosanganisira zviratidzo zvekuyerera weti zvenguva pfupi izvo zvinowanzoenda mukati memavhiki. Unogona kunzwa kupisa paunenge uchiyerera weti, kuwedzera kakawanda, kana kukurumidza sezvo muviri wako uchipora. Vamwe varume vanoona ropa mumvura yavo yeweti kwemazuva akati wandei, izvo zvakajairika chero bedzi zvichiderera zvishoma nezvishoma.

Zvimwe zvinokonzera kunetseka, kunyange zvazvo zvisingawanzoitiki, zvinoda kutarisirwa kwekurapa nekukurumidza. Izvi zvinosanganisira:

• Kubuda ropa zvakanyanya nemagwamba makuru asingamire
• Kusagona zvachose kuyerera weti mushure mekubviswa kwe catheter
• Zviratidzo zveutachiona zvakaita sefivha, kutonhora, kana kupisa zvakanyanya
• Kurwadziwa kwakanyanya kusingavandudzwi nemishonga yakarairwa

Zvinogona kuitika kwenguva refu hazviwanzoitiki asi zvinogona kusanganisira urethral stricture (kumanikidzwa kwe urethra), izvo zvingada kumwe kurapwa. Vamwe varume vanonzwa retrograde ejaculation, uko mbeu inoenda kumashure muura panguva yekukwirira, kunyange izvi zvisingakanganisi kugona kuva neorgasms.

Chinhu chakakosha ndechokuchengetedza kutaurirana kwakavhurika nechikwata chako chehutano uye kushuma chero zviratidzo zvinonetsa nekukurumidza. Zvizhinji zvezvinhu zvinogona kuitika zvinogona kubatwa zvakanaka kana zvabatwa pakutanga.

Ndingafonera chiremba rini mushure mekuvhiyiwa kwe prostate neraser?

Unofanira kubata chiremba wako nekukurumidza kana ukaona kubuda ropa zvakanyanya, usingakwanisi kuyerera weti, kana kuwana zviratidzo zveutachiona mushure mekuvhiyiwa kwako kwe prostate neraser. Kubuda ropa zvakanyanya zvinoreva kupfuudza magwamba makuru, kuva nemvura yeweti yakajeka tsvuku isingajeki nekuwedzera kwemvura, kana kunzwa kusimba uye dzungu.

Zviratidzo zveutachiona zvinoda kutarisirwa kwekurapa nekukurumidza uye zvinosanganisira fivha inodarika 101°F (38.3°C), kupisa kwakanyanya kunowedzera pane kuvandudza, weti inonhuwirira, kana kutonhora uye kurwadziwa kwemuviri. Zviratidzo izvi zvinogona kuratidza utachiona hweurinary tract hunoda kurapwa nemishonga inorwisa mabhakitiriya.

Kukundikana zvachose kuita weti mushure mekubviswa kwecatheter yako idambudziko rekurapa rinoda kutarisirwa nekukurumidza. Kunyange zvazvo kuoma kwakawanda pakutanga kuita weti kwakajairika, kana usingakwanisi kuburitsa weti kwemaawa 6-8 pasinei nekunzwa chido, unoda kuongororwa kwekurapa nekukurumidza.

Kuti utarise nguva dzose, vanachiremba vazhinji vanoronga misangano pavhiki 1-2, vhiki 6, uye mwedzi mitatu mushure mekuvhiyiwa. Kushanya uku kunobvumira chiremba wako kuti atarise kufambira mberi kwako kwekurapa, aongorore kuvandudzwa kwezviratidzo, uye agadzirise chero zvaungave nazvo pamusoro pekupora kwako.

Mibvunzo inowanzo bvunzwa pamusoro pekuvhiyiwa kweprostate laser

Q.1 Kuvhiyiwa kweprostate laser kwakanaka here kune maprostates makuru kwazvo?

Hongu, mamwe marudzi ekuvhiyiwa kwe laser anogona kubata maprostates makuru kwazvo, kunyange zvazvo nzira chaiyo ichikosha. HoLEP (Holmium Laser Enucleation of Prostate) inonyanya kushanda kune maprostates anodarika 80-100 gramu, ichipa mhedzisiro yakanaka kunyange kumaguru akakura zvakanyanya.

Kune maprostates makuru kwazvo, kuvhiyiwa kunogona kutora nguva yakareba uye kunoda hunyanzvi hwakawanda, asi varume vazhinji vane maprostates akakura zvakanyanya vanowana zororo rakakura rezviratidzo. Urologist wako achaongorora anatomy yako chaiyo kuti aone kana kuvhiyiwa kwe laser kwakakodzera kana kuti nzira dzechinyakare dzingave dziri nani.

Q.2 Kuvhiyiwa kwe laser kunokonzera kusashanda zvakanaka kwenguva refu here?

Aihwa, kuvhiyiwa kweprostate laser kazhinji hakukonzere kusashanda zvakanaka kwenguva refu. Maitiro e laser akagadzirirwa kuchengetedza tsinga dzine basa rekuita erectile function, uye varume vazhinji vanochengetedza kugona kwavo erectile vasati vavhiyiwa.

Asi, vamwe varume vanogona kusangana nekuchinja kwenguva pfupi mukushanda kwepabonde panguva yekupora. Izvi zvinowanzoita zvakanaka mukati mevhiki 6-12 sezvo kuzvimba kunoderera uye matishu anopora. Kana uine matambudziko ekuvaka muviri usati wavhiyiwa, maitiro acho haazovagadzirise, asi haafaniri kuita kuti ave akaipawo.

Q.3 Ndingazvikwanisa here kutyaira ndichidzokera kumba mushure mekuvhiyiwa kweprostate laser?

Kwete, haugone kuzvityaira kumba mushure mekuvhiyiwa kweprostate laser nekuti uchave wagamuchira anesthesia uye unogona kunge uine catheter panzvimbo. Unozoda mumwe munhu kuti akutyairire kumba uye agare newe kwemaawa makumi maviri nemana ekutanga.

Varume vazhinji vanogona kutangazve kutyaira mukati memazuva 2-3 kana vachibva pamishonga yekurwadziwa, vachinzwa vakangwarira, uye vanogona kugara zvakanaka. Zvisinei, unofanira kudzivisa kutyaira uine catheter panzvimbo, sezvo inogona kusagadzikana uye kukanganisa.

Q.4 Ndichatora nguva yakareba sei ndisati ndakwanisa kurovedza muviri zvakajairika mushure mekuvhiyiwa kwe laser?

Unogona kazhinji kudzokera kune zvakajairika kurovedza muviri zvishoma nezvishoma pamusoro pemavhiki 4-6 mushure mekuvhiyiwa kweprostate laser. Kufamba zvishoma kunokurudzirwa kubva pazuva rekutanga, asi unofanira kudzivisa kusimudza zvinhu zvinorema, kumhanya, kana mabasa akaoma kwemwedzi wekutanga.

Tanga nemabasa akapfava sekufamba uye zvishoma nezvishoma wedzera simba sezvaunonzwa wakasununguka. Dzivisa mabasa anosanganisira kusimba, kusimudza zvinhu zvinorema (kupfuura mapaundi gumi), kana kufamba kunovhundutsa kusvikira chiremba wako akubvumira, kazhinji anenge mavhiki 4-6 mushure mekuvhiyiwa.

Q.5 Ndichada kuvhiyiwa zvakare mune ramangwana here?

Varume vazhinji havadi kuvhiyiwa zvakare mushure mekubudirira prostate laser surgery, vane mibairo yenguva refu inenge 85-90%. Tishu inobviswa haikuri zvakare, saka mabhenefiti ekukurumidza anowanzoita echigarire.

Zvisinei, tishu ye prostate yasara inogona kuramba ichikura zvishoma nezvishoma kwemakore mazhinji. Vamwe varume vangada imwe kurapwa makore gumi-15 gare gare, asi izvi zvinosiyana zvakanyanya pakati pevanhu. Kutevera nguva dzose ne urologist wako kunobatsira kutarisa kufambira mberi kwenguva refu uye kugadzirisa chero shanduko kare.