Adenomyosis

I-Adenomyosis (ad-uh-no-my-O-sis) kwenzeka lapho ithusi evamise ukumboza i-uterus (ithishu ye-endometrial) ikhula ngaphakathi odongeni oluqinile lwe-uterus. Ithishu ehambile iyaqhubeka isebenza ngokujwayelekile—ibukhulu, iphule futhi igazi—ngesikhathi sokujikeleza kwesikhathi ngasinye. I-uterus enkulu kanye nezikhathi ezibuhlungu, ezisindayo zingabangela.

Odokotela abaqiniseki ukuthi yini ebangela i-adenomyosis, kodwa leyo gciwane ivame ukuqeda ngemuva kwe-menopause. Kwabesifazane abanezinhlungu ezinzima ezivela kwi-adenomyosis, ukwelashwa kwe-hormonal kungasiza. Ukususa i-uterus (i-hysterectomy) kuyaphilisa i-adenomyosis.

Ngesinye isikhathi, i-adenomyosis ayibangeli zimpawu noma izimpawu noma ubuhlungu obuncane nje kuphela. Kodwa-ke, i-adenomyosis ingabangela:

• Ukopha okukhulu noma okwesabekayo
• Ubuhlungu obukhulu noma obukhulu, obukhulu njengoba bukhulu ngesikhathi sokuphuza (i-dysmenorrhea)
• Ubuhlungu obuhlala isikhathi eside be pelvis
• Ubuhlungu ngesikhathi socansi (i-dyspareunia)

Umathumbu wakho angakhula. Nakuba ungase ungazi ukuthi umathumbu wakho mkhulu kangakanani, ungase uqaphele ubuhlungu noma ukucindezela ngaphansi kwesisu sakho.

Uma unegazi elide, elinzima noma ukubamba okunzima phakathi nezinsuku zakho zokuba nesisu okuphazamisa imisebenzi yakho yansuku zonke, yenza i-aphoyintimenti ukubona udokotela wakho.

Imbangela ye-adenomyosis ayaziwa. Kube khona amazinga amaningi, okuhlanganisa:

• Ukukhula kwezicubu ezifakayo. Abanye ochwepheshe bakholelwa ukuthi amangqamuzana e-endometrial avela ekuqaleni kwesisu angena emsinyweni oqamba izindonga zesisu. Ukuthungwa kwesisu okwenziwe ngesikhathi sokuhlinzwa njengokuhlinzwa kwe-cesarean (i-C-section) kungase kukhuthaze ukungena ngqo kwamangqamuzana e-endometrial odongeni lwesisu.
• Imvelaphi yokuthuthukiswa. Abanye ochwepheshe baphikisa ukuthi i-endometrial tissue ifakwe emsinyweni wesisu lapho isisu sakhiwa okokuqala ngqa esiswini somntwana.
• Ukuvuvukala kwesisu okuhlobene nokubeletha. Enye ingqondo iphakamisa ukuxhumana phakathi kwe-adenomyosis nokubeletha. Ukuvuvukala kokugqoka kwesisu ngesikhathi sokubeletha kungase kubangele ukuphulwa kwemingcele evamile yamangqamuzana aqopha isisu.
• Imvelaphi yeseli yesiqalo. Ingqondo yakamuva iphakamisa ukuthi amangqamuzana esiqalo le-bone marrow angase angene emsinyweni wesisu, abangele i-adenomyosis.

Kungakhathaliseki ukuthi i-adenomyosis ithuthuka kanjani, ukukhula kwayo kuncike ku-estrogen ehamba egazini lomzimba.

Izimbangela ezingozi ze-adenomyosis zihlanganisa:\n\n* Ukuhlinzwa kwesisu ngaphambili, njengokuhlinzwa kwe-C-section, ukususwa kwe-fibroid, noma ukwandiswa nokuhlanzwa (D&C)\n* Ukukhulelwa\n* Ubudala obuphakathi\n\Amacala amaningi e-adenomyosis—aqondene ne-estrogen—atholakala kwabesifazane abaneminyaka engama-40 nama-50. I-adenomyosis kulaba besifazane ingase ibe nobudlelwano nokutholakala isikhathi eside ku-estrogen uma kuqhathaniswa nabesifazane abasebancane. Noma kunjalo, ucwaningo lwamanje luphakamisa ukuthi le simo lingase libe lula nakwabesifazane abasebancane.

Uma uvame ukuba nokuphuza igazi isikhathi eside, okukhulu ngesikhathi sakho sokuba nesikhathi, ungathuthukisa isifo se-anemia esingapheli, esibangela ukukhathala nezinye izinkinga zempilo.

Nakuba kungabi yingozi, ubuhlungu nokuphuza igazi okukhulu okuhambisana ne-adenomyosis kungaphazamisa indlela yakho yokuphila. Ungase ugweme imisebenzi obuyijabulela esikhathini esidlule ngoba ubuhlungu noma ukhathazeka ngokuthi ungaqala ukuphuza igazi.

Ezinye izimo zebele lombewu zingabangela izimpawu ezifanayo nalezo ze-adenomyosis, okwenza kube nzima ukuxilonga i-adenomyosis. Lezi zimo zihlanganisa iziphumu ze-fibroid (leiomyomas), amangqamuzana ebele lombewu akhula ngaphandle kwebele lombewu (endometriosis) kanye nokwanda okukhula ekuqaleni kwebele lombewu (endometrial polyps).

Udokotela wakho angase aphethe ngokuthi une-adenomyosis kuphela ngemuva kokususwa ezinye izimbangela ezingase zibe khona zezimpawu zakho.

Udokotela wakho angase athambekele ekukholelweni ukuthi une-adenomyosis ngokususelwa ku:

Kwezinye izikhathi, udokotela wakho angase aqoqe isampula yethishu yebele lombewu ukuze ayihlole (endometrial biopsy) ukuqinisekisa ukuthi awunayo isimo esibucayi kakhulu. Kodwa-ke, i-endometrial biopsy ngeke imsize udokotela wakho ukuqinisekisa ukuxilongwa kwe-adenomyosis.

Izithombe ze-pelvic ezifana ne-ultrasound ne-Magnetic resonance imaging (MRI) zingabona izimpawu ze-adenomyosis, kodwa-ke indlela kuphela yokukuqinisekisa iwukuhlola ibele lombewu ngemuva kwe-hysterectomy.

• Izimpawu
• Ukuhlolwa kwe-pelvic okwembula ibele lombewu elikhulu, elibuhlungu
• Ukwenza izithombe ze-ultrasound zebele lombewu
• Ukwenza izithombe ze-Magnetic resonance imaging (MRI) zebele lombewu

I-adenomyosis ivame ngokuvamile ngemva kokuphela kwesikhathi, ngakho ukwelashwa kungase kuncike ekuqondeni ukuthi useduze kangakanani naleli zinga lokuphila.

Amakhetho okwelapha i-adenomyosis afaka:

• Imithi yokulwa nokuvuvukala. Udokotela wakho angase akukhuthaze imithi yokulwa nokuvuvukala, njenge-ibuprofen (Advil, Motrin IB, nabanye), ukulawula ubuhlungu. Ngokuqala imithi yokulwa nokuvuvukala usuku olulodwa noma amabili ngaphambi kokuba kuqale isikhathi sakho bese uyithatha ngesikhathi sakho, unganciphisa ukugeleza kwegazi lesikhathi futhi usize ukunciphisa ubuhlungu.
• Imithi yamahomoni. Amaphilisi okuzala ahlanganisa i-estrogen-progestin noma izipende ezinamahomoni noma ama-ring e-vaginal angase anciphise ukugeleza okukhulu kwegazi nobuhlungu obuhambisana ne-adenomyosis. Ukuphathwa kokuzala kwe-progestin kuphela, njenge-intrauterine device, noma amaphilisi okuzala asebenzisa njalo ngokuvamile abangela i-amenorrhea - ukungabikho kwesikhathi sakho - okungase kunikeze impumuzo ethile.
• Ukuhlinzwa kwe-hysterectomy. Uma ubuhlungu bakho bukhulu futhi akukho ukwelashwa okunye okuye kwasebenza, udokotela wakho angase akuphakamise ukuhlinzwa ukuze ususe isisu sakho. Ukukhipha ama-ovari akudingeki ukulawula i-adenomyosis.