Chii chinonzi Prostatectomy? Chinangwa, Maitiro & Kupora

Prostatectomy inzira yekuvhiya yekubvisa zvose kana chikamu chechinyamupfupi cheprostate. Kurapa uku kunowanzo kurairwa varume vane gomarara reprostate, kunyange zvazvo zvichigona kubatsirawo nemhando dzakakomba dze prostate yakakura isina kupindura kune dzimwe nzira dzekurapa.

Prostate igland diki, yakaita senzungu inogara pasi pechitsama chako uye yakapoteredza urethra. Kana gomarara rikabuda kana kuti gland ikakura zvakanyanya, kuibvisa nekuvhiya kunogona kuva nzira inonyanya kushanda yekudzivirira utano hwako uye kuvandudza hupenyu hwako.

Chii chinonzi prostatectomy?

Prostatectomy zvinoreva kubvisa gland ye prostate kubva mumuviri wako nekuvhiya. Kune mhando mbiri huru: radical prostatectomy inobvisa yese gland ye prostate uye imwe tishu yakapoteredza, nepo simple prostatectomy inobvisa chete chikamu chemukati cheprostate.

Radical prostatectomy ndiyo kurapwa kwakajairika kwegomarara re prostate rakaganhurirwa. Munguva iyi nzira, chiremba wako anobvisa yese gland ye prostate, seminal vesicles (madiki madiki anogadzira mvura ye semen), uye dzimwe nguva lymph nodes dzepedyo kuti aone kupararira kwegomarara.

Simple prostatectomy haisi yakajairika uye inowanzo chengeterwa varume vane prostates yakakura kwazvo inokonzera matambudziko akakomba ekuyera. Iyi nzira inobvisa chete tishu yakakura inodzivisa kuyerera kweweti, ichisiya goko rekunze re prostate rakazara.

Nei prostatectomy ichiitwa?

Prostatectomy inonyanya kuitwa kurapa gomarara re prostate risina kupararira kupfuura gland ye prostate. Chiremba wako angakuraira kuvhiyiwa uku kana uine gomarara remutangiro uye uine hutano hwakakwana hwekuvhiyiwa kukuru.

Chinangwa chikuru ndechekubvisa zvachose gomarara kubva mumuviri wako usati wava nemukana wekupararira kune dzimwe nhengo. Izvi zvinokupa mukana wakanaka wekusava negomarara kwenguva refu, kunyanya kana gomarara rakabatwa kare uye rakaganhurirwa kune prostate.

Kazhinji, prostatectomy inogona kurairwa kana uine benign prostatic hyperplasia (prostate yakakura) yakanyanya apo mishonga nemamwe marapirwo asina kubatsira zviratidzo zvako. Izvi zvinowanzoitika kuvarume vane prostate hombe kwazvo zvichikonzera matambudziko akakomba ekuyera weti kana kukuvadzwa kwematsvo.

Ndeipi nzira ye prostatectomy?

Nzira yekuvhiya inoenderana nemamiriro ako chaiwo uye hunyanzvi hwevachiremba vako. Mazhinji eprostatectomies nhasi anoitwa vachishandisa nzira diki dzinokonzera kucheka kudiki uye nguva yekupora nekukurumidza.

Robot-assisted laparoscopic prostatectomy ndiyo nzira inowanzoitwa parizvino. Chiremba wako anovhiya kuburikidza nekucheka kudiki achishandisa zviridzwa zve robotic zvinopa kurongeka kwakawedzerwa uye 3D visualization. Iyi nzira inowanzoita kuti ropa rishome, kuderedzwa kwemarwadzo, uye kupora nekukurumidza kana ichienzaniswa nekuvhiya kwechinyakare.

Panguva yekuvhiya, uchave pasi pe general anesthesia uye hauzonzwe chinhu. Chiremba wako anonyatso paradzanisa prostate kubva kune zvakatipoteredza, kusanganisira bladder uye urethra, wobva abvisa gland zvachose. Iyo bladder inobva yabatanidzwa kune urethra.

Open radical prostatectomy inosanganisira kucheka kukuru mudumbu rako rezasi. Kunyange zvazvo zvisingawanzoitiki zvino, iyi nzira inogona kuva yakakosha kune prostate hombe kwazvo kana apo kuvhiyiwa kwakapfuura kwakagadzira tishu inokuvadza inoita kuti nzira diki dzive dzakaoma.

Maitiro ekugadzirira prostatectomy yako?

Kugadzirira kwako kunotanga mavhiki akati wandei kuvhiya nekuongororwa kwakakwana uye kuronga. Chikwata chako chekurapa chichaita kuti uve neutano hwakakwana hwekuvhiya uye kukubatsira kunzwisisa zvaunotarisira panguva yekupora.

Unofanira kumisa mishonga yakati wandei inogona kuwedzera njodzi yekubuda ropa, senge mishonga yekutadzisa ropa, aspirin, uye mamwe mavitamini. Chiremba wako achakupa mirairo yakajeka yekuti imishonga ipi yekumisa uye rini. Usambomisa mishonga yakarairwa usati wambotaura nechikwata chako chehutano kutanga.

Kuedzwa kusati kwavhiyiwa kunowanzo sanganisira kuongororwa kweropa, kuongororwa kwemifananidzo, uye dzimwe nguva mamwe mwoyo kana mapapu ekushanda. Izvi zvinobatsira chikwata chako chevhiyiya kuronga nzira yakanakisa yezvako zvakajeka zvemuviri uye hutano.

Zuva risati ravhiyiwa, unofanira kutevera zvirambidzo zvakakosha zvekudya. Vanhu vazhinji vanokumbirwa kudya chikafu chakareruka manheru asati avhiyiwa uye wobva wadzivisa zvese zvekudya nekunwa mushure mepakati peusiku. Kugadzirira kwako ura kungasanganisira enema kana laxative kuti uve nechokwadi chekuti matumbu ako akachena.

Ungaverenga sei mhedzisiro yako ye prostatectomy?

Mushumo wako wepathology unopa ruzivo rwakadzama nezve gomarara rakawanikwa mune prostate yako yakabviswa. Mushumo uyu unobatsira kuona kana imwe kurapwa kuchidikanwa uye unopa ruzivo mukuona kwako kwenguva refu.

Chiremba wepathologist achaongorora prostate yako yese pasi pemicroscope uye anoshuma zvinhu zvakakosha zvakati wandei. Iyo Gleason score inotsanangura kuti maseru egomarara anoita sei, nemapoinzi akaderera achiratidza gomarara rinokura zvishoma. Zvikoro zvinobva pa6 kusvika ku10, ne6 iri iyo isinganyanyi kuita.

Miganhu yekuvhiya inokuudza kana maseru egomarara akawanikwa pamativi etishu yakabviswa. Miganhu yakajeka zvinoreva kuti chiremba akabvisa gomarara rese rinoonekwa, nepo miganhu yakanaka ingaratidza maseru egomarara microscopic anoramba aripo uye imwe kurapwa inogona kubatsira.

Nhanho yepathological inotsanangura kuti gomarara rakanga rapararira sei mukati meprostate uye kana rakatambanuka kupfuura gland. Ruzivo urwu, rwakasanganiswa nemiedzo yako isati yavhiyiwa, runobatsira chikwata chako chekurapa kuona kana uchida mamwe marapirwo senge radiation therapy.

Ungaita sei kuti kupora kwako kwe prostatectomy kuve nani?

Kupora kubva kuprostatectomy inzira inononoka iyo inowanzo tora mavhiki akati wandei kusvika kumwedzi. Kutevera mirairo yechiremba wako zvakanyatsonaka kunobatsira kuona mhedzisiro yakanakisa uye kunoderedza njodzi yako yematambudziko.

Kutarisira kurwadziwa kwakakosha mumazuva mashoma ekutanga mushure mekuvhiyiwa. Chikwata chako chekurapa chichapa mishonga yekukuchengeta wakasununguka, uye kurwadziwa kunowanzo kudzikira zvakanyanya mukati mevhiki rekutanga. Vazhinji varwere vanowana zvinoderedza kurwadziwa zvisina simba zvakakwana mushure memazuva mashoma ekutanga.

Uchava ne catheter yeurinary kwemavhiki anenge rimwe kusvika kumaviri mushure mekuvhiyiwa. Iri chubhu rakatetepa rinobvisa weti kubva mudundira rako apo hukama pakati pedundira rako ne urethra richipora. Kunyangwe zvisingakodzeri, catheter yakakosha pakupora kwakakodzera uye kudzivirira matambudziko.

Zvirambidzo zvekuita zvemuviri zvinobatsira kuchengetedza matishu ako anopora. Uchada kudzivisa kusimudza zvinhu zvinorema, kurovedza muviri zvakanyanya, uye kutyaira kwemavhiki akati wandei. Zvisinei, kufamba zvinyoro-nyoro kunokurudzirwa kubva pazuva rekutanga mushure mekuvhiyiwa kudzivirira magwamba eropa uye kusimudzira kupora.

Ndezvipi zvinhu zvine njodzi zvematambudziko eprostatectomy?

Nepo prostatectomy ichiwanzo chengeteka, zvinhu zvakati wandei zvinogona kuwedzera njodzi yako yematambudziko. Kunzwisisa izvi kunobatsira iwe nechikwata chako chekurapa kutora matanho akakodzera uye kuita sarudzo dzine ruzivo nezvekutarisirwa kwako.

Zera uye hutano hwese hunokanganisa zvakanyanya njodzi yako yekuvhiya. Varume vanopfuura makore 70 kana avo vane chirwere chemoyo, chirwere cheshuga, kana mamwe mamiriro echronic vanotarisana nenjodzi dzakakwirira dzematambudziko. Zvisinei, varume vakawanda vakuru vanobudirira kuita prostatectomy nemhedzisiro yakanaka.

Mavhiyiwa emudumbu apfuura kana radiation therapy inogona kuita kuti maitiro acho ave akaoma. Tishu yemaronda kubva mukurapa kwapfuura inogona kuita kuti zvive zvakaoma kuti machiremba azive ndege dzakajairika dzematishu, zvichikwanisa kuwedzera nguva yekushanda uye njodzi yematambudziko.

Saizi re prostate uye huwandu hwekenza zvinokanganisawo mazinga e njodzi. Maprostate makuru kwazvo kana kenza yakakura pedyo nemavakirwo akapoteredza inogona kuda nzira dzakaoma dzekuvhiya, zvichikwanisa kuwedzera mukana we matambudziko.

Kusvuta uye kufutisa zvinhu zvinogadziriswa zvinokanganisa njodzi zvaunogona kugadzirisa usati wavhiyiwa. Kusvuta kunokanganisa kupora kwemaronda uye kunowedzera njodzi yekutapukirwa, nepo uremu hwakawandisa hunogona kuita kuti kuvhiyiwa kuve kwakaoma uye kunonotsa kupora.

Ndezvipi zvingaitika zvinogona kuitika zve prostatectomy?

Semamwe mavhiyiwa makuru, prostatectomy inotakura njodzi dzinogona kuitika uye matambudziko. Varume vazhinji havawani matambudziko akakomba, asi kunzwisisa zvinogona kuitika zvinokubatsira kuti uite zvisarudzo zvine ruzivo uye kuziva kana uchida kutsvaga rubatsiro rwekurapa.

Matambudziko anowanzoitika anokanganisa basa re urinary uye re bonde. Nyaya idzi dzinowanzoitika kwenguva pfupi asi dzimwe nguva dzinogona kuve dzechigarire, zvichienderana nezvinhu zvakasiyana zvinosanganisira zera rako, hutano hwako hwese, uye huwandu hwekuvhiya hunodiwa.

Heano matambudziko makuru ekuziva nezvawo:

• Kusagadzikana kwe urinary: Kuoma kudzora kuyerera kweweti kunokanganisa varume vazhinji pakutanga asi kazhinji kunovandudzika nekufamba kwenguva. Kupora kwakakwana kwekutonga kwe bladder kunogona kutora mwedzi yakati wandei kusvika gore.
• Kushaya simba re erectile: Kuoma kuwana kana kuchengetedza erections kunowanzoitika mushure mekuvhiyiwa. Kupora kunoenderana nezera, basa risati ravhiyiwa, uye kana nzira dzekuchengetedza tsinga dzakakwanisika.
• Kubuda ropa: Kumwe kubuda ropa kwakajairika, asi kubuda ropa kwakanyanya kunogona kuda imwe kurapwa kana kazhinji, kuwedzerwa kweropa.
• Kutapukirwa: Zvirwere zvekukuvadzwa kwekuvhiya kana zvirwere zve urinary tract zvinogona kuitika asi zvinowanzoitika kurapwa nemishonga inorwisa mabhakitiriya.
• Kuumbwa kwe stricture: Nyama yemaronda inogona kudzikisa hukama pakati pe bladder ne urethra, zvichikwanisa kuda mamwe maitiro.

Zvimwe zvinetso zvakakomba asi zvisingawanzoitika zvinosanganisira magwamba eropa, matambudziko emoyo, kana kukuvara kwematumbu. Chikwata chako chekuvhiya chinonyatso tarisa matambudziko aya uye chine nzira dzekuagadzirisa kana akaitika.

Ndingafonera chiremba rini mushure meprostatectomy?

Kutevera nguva dzose mushure meprostatectomy kwakakosha kuti utarise kupora kwako uye utarise chero zviratidzo zvekuvazve kwekenza. Chikwata chako chekurapa chichaita nguva dzakatarwa, asi iwe unofanirwawo kuziva kuti ungatsvaga rini rubatsiro rwekurapa nekukurumidza.

Fonera chiremba wako nekukurumidza kana uine kurwadziwa kukuru kusingadzorwe nemishonga yakarairwa, zviratidzo zveutachiona senge fivha kana kutonhora, kana kubuda ropa zvakanyanya. Zviratidzo izvi zvinogona kuratidza matambudziko anoda kurapwa nekukurumidza.

Matambudziko necatheter yako yeweti anodawo kutariswa nekukurumidza. Kana catheter ikamira kuyerera, ikabviswa, kana kukonzera kurwadziwa kukuru, fonera chikwata chako chekurapa nekukurumidza. Usaedze kugadzirisa matambudziko ecatheter iwe pachako.

Kutevera kwenguva refu kunowanzo sanganisira bvunzo dzeropa dzePSA dzenguva dzose kuti utarise kuwanzve kwekenza. Chiremba wako achatarisawo kupora kwako kwemabasa eweti uye epabonde uye achapa kurapwa kana kutumira kana zvichidikanwa.

Mibvunzo inowanzo bvunzwa nezve prostatectomy

Q.1 Ko prostatectomy yakanaka here kune kenza yeprostate yematanho ekutanga?

Hongu, prostatectomy inoonekwa seimwe yeanonyanya kushanda kurapwa kwekenza yeprostate yematanho ekutanga. Kana kenza yakavharirwa mugland ye prostate, kubviswa kwekuvhiya kunopa mitengo yakanaka yekurapa uye mhedzisiro yekupukunyuka kwenguva refu.

Mukana mukuru ndiko kubviswa kwakakwana kwekenza, iyo inobvisa njodzi yekuti bundu rikure kana kupararira kubva ku prostate. Zvidzidzo zvinoratidza kuti varume vane kenza yeprostate yakaganhurirwa vanoita prostatectomy vane mitengo yekupukunyuka inofananidzwa nevarume vasina kenza.

Q.2 Ko prostatectomy inokonzera kusagadzikana zvachose here?

Varume vazhinji vanodzora weti mushure meprostatectomy, kunyangwe zvichitora nguva. Kusakwanisa kuzvidzora weti kwakakwana hakusi kwakajairika, kuchikanganisa vanenge 5-10% yevanhu kwenguva refu. Ruzhinji rwevarwere rwunowana kugadzirisa kweweti kunogutsa mukati memwedzi mitanhatu kusvika gore.

Kupora kunoenderana nezvinhu zvakati wandei zvinosanganisira zera, basa rebladder risati raitwa kuvhiyiwa, uye nzira yekuvhiya. Maekisesaizi epelvic floor nemamwe marapirwo anogona kubatsira kumhanyisa kupora uye kuvandudza mhedzisiro yevanhu vazhinji.

Mubvunzo 3: Ndingada here kumwe kurapwa kwekenza mushure meprostatectomy?

Varume vazhinji havadi kumwe kurapwa mushure meprostatectomy yakabudirira. Zvisinei, vanenge 20-30% yevanhu vangabatsirwa nekurapa nemwaranzi kana mhedzisiro yepathology ikaratidza zvinhu zvine njodzi yakakwirira senge positive margins kana cancer extension kupfuura prostate.

Chikwata chako chekurapa chichaongorora mhedzisiro yako yepathology uye chichakurudzira kumwe kurapwa chete kana zvichikwanisika kuvandudza mhedzisiro yako yenguva refu. Kuongororwa kwePSA nguva dzose kunobatsira kuona chero zviratidzo zvekudzoka kwekenza kare.

Mubvunzo 4: Zvinotora nguva yakareba sei kupora kubva kuprostatectomy?

Kupora kwekutanga kunotora anenge 4-6 mavhiki, panguva yaunozodzokera zvishoma nezvishoma kuzviitiko zvakajairika. Zvisinei, kupora kwakakwana kwebasa reweti uye rebonde kunogona kutora mwedzi 6-12 kana kupfuura.

Varume vazhinji vanodzokera kubasa mukati memavhiki 2-4, zvichienderana nezvinodiwa nebasa ravo. Kusimudza zvinhu zvinorema uye zviitiko zvakanyanya zvinowanzoitwa zvakaganhurirwa kwemavhiki 6-8 kuti zvitendere kupora kwakakodzera.

Mubvunzo 5: Prostatectomy inogona kuitwa nemaitiro mashoma anopinda here?

Hongu, prostatectomies zhinji nhasi dzinoitwa vachishandisa minimally invasive robotic kana laparoscopic techniques. Iyi nzira inopa zvakanakira zvakati wandei zvinosanganisira kucheka kudiki, kurasikirwa neropa shoma, kuderedzwa kwemarwadzo, uye kupora nekukurumidza zvichienzaniswa nekuvhiya kwechinyakare kwakavhurika.

Robot-inobatsira prostatectomy yave nzira inowanzoitwa nekuti inopa vanachiremba kurongeka kwakanyanya uye kuona kwe3D. Zvisinei, nzira yakanakisisa yekuvhiya inoenderana nemamiriro ako chaiwo uye hunyanzvi hwevachiremba vako.