Yini i-Myomectomy? Inhloso, Inqubo & Ukululama

I-myomectomy iyinqubo yokuhlinzwa esusa ama-fibroids esibelethweni ngenkathi igcina isibeletho sakho singathinteki. Lokhu kuhlinzwa kunikeza ithemba kwabesifazane abafuna ukugcina inzalo yabo noma bamane bagcine isibeletho sabo ngenkathi bethola ukukhululeka ezimpawini ze-fibroid.

Ngokungafani ne-hysterectomy, esusa lonke isibeletho, i-myomectomy iqondisa kuphela ama-fibroids anezinkinga. Lokhu kuyenza ibe yindlela ekhangayo kwabesifazane abahlela ukuba nezingane esikhathini esizayo noma abakhetha ukugcina i-anatomy yabo yokuzala.

Yini i-myomectomy?

I-Myomectomy iyindlela yokuhlinzwa eqondiwe esusa ama-fibroids esibelethweni sakho ngenkathi igcina ilungu ngokwalo. Igama livela ku-“myo” okusho imisipha kanye ne-“ectomy” okusho ukususwa, okubhekisela emsipheni owakha ama-fibroids.

Ngesikhathi sale nqubo, udokotela ohlinzayo wakho ukhomba ngokucophelela futhi asuse i-fibroid ngayinye ngenkathi akha kabusha udonga lwesibeletho. Umgomo uwukuqeda izimpawu ngenkathi kugcinwa isakhiwo somzimba wakho kanye nomsebenzi wokukhulelwa okuzayo uma ufisa.

Lokhu kuhlinzwa kungenziwa ngezindlela ezahlukene kuye ngosayizi, inani, nendawo yama-fibroids akho. Udokotela ohlinzayo wakho uzokhetha indlela enikeza imiphumela engcono kakhulu ngendlela encane yokuhlasela ngangokunokwenzeka.

Kungani i-myomectomy yenziwa?

I-Myomectomy iba yimfuneko lapho ama-fibroids edala izimpawu ezibalulekile eziphazamisa impilo yakho yansuku zonke kanye nekhwalithi yokuphila. Isizathu esivame kakhulu ukuphuma kwegazi eliningi lokuya esikhathini elingasabeli kwezinye izindlela zokwelapha.

Ungase udinge lokhu kuhlinzwa uma uhlangabezana nobuhlungu obukhulu be-pelvic, ingcindezi, noma ukuqaqamba okuthinta ikhono lakho lokusebenza, ukuzivocavoca, noma ukujabulela imisebenzi. Abesifazane abaningi futhi bakhetha i-myomectomy lapho ama-fibroids edala ukuvama ukuchama noma ubunzima bokukhipha umchamo wabo ngokuphelele.

Ukukhathazeka ngokuzala kuvame ukushayela isinqumo se-myomectomy. Uma ama-fibroids ephazamisa ikhono lakho lokukhulelwa noma lokuthwala ukukhulelwa kuze kube sekupheleni, ukuwasusa kungathuthukisa amathuba akho okuqala ukukhulelwa ngempumelelo nokubeletha.

Abanye besifazane bakhetha i-myomectomy lapho ama-fibroids edala ukuvuvukala kwesisu okuqaphelekayo noma lapho ezinye izindlela zokwelapha njengemithi noma izinqubo ezingahlaseli kakhulu zingazange zinikeze ukukhululeka okwanele.

Yini inqubo ye-myomectomy?

Inqubo ye-myomectomy iyahluka ngokuya ngendlela yokuhlinzwa udokotela wakho ayincomayo. Kunezinhlobo ezintathu eziyinhloko, ngasinye senzelwe ukufinyelela ama-fibroids ezindaweni ezihlukene ngaphakathi kwesibeletho sakho.

I-Laparoscopic myomectomy isebenzisa ukusikeka okuncane esiswini sakho kanye namathuluzi akhethekile ukususa ama-fibroids. Udokotela ohlinzayo ufaka ikhamera encane ebizwa nge-laparoscope ukuze aqondise inqubo ngenkathi esusa ama-fibroids ngalezi zindawo ezincane.

I-Hysteroscopic myomectomy ifinyelela ama-fibroids ngesitho sakho sangasese kanye nomlomo wesibeletho ngaphandle kwanoma yikuphi ukusikeka kwangaphandle. Le ndlela isebenza kahle kakhulu kuma-fibroids akhula ngaphakathi emgodini wesibeletho futhi abangele ukuphuma kwegazi okukhulu.

I-Myomectomy evulekile ihlanganisa ukusikeka okukhulu kwesisu, okufana nesigaba se-cesarean. Le ndlela ngokuvamile igcinelwe ama-fibroids amakhulu, ama-fibroids amaningi, noma lapho ukuhlinzwa kwangaphambilini kudale izicubu ezinamanxeba ezenza izindlela ezingahlaseli kancane zibe yinselele.

Ngesikhathi sanoma iyiphi indlela ye-myomectomy, udokotela wakho ohlinzayo uzosusa ngokucophelela i-fibroid ngayinye ngenkathi egcina izicubu zesibeletho ezinempilo. Le nqubo ngokuvamile ithatha ihora elilodwa kuya kwamathathu kuye ngobunzima becala lakho.

Ungalungiselela kanjani i-myomectomy yakho?

Ukulungiselela i-myomectomy kuqala emasontweni ambalwa ngaphambi kosuku lokuhlinzwa kwakho. Udokotela wakho cishe uzonquma imithi yokunciphisa ama-fibroids akho nokunciphisa ukuphuma kwegazi, okwenza ukuhlinzwa kuphephe futhi kuphumelele.

Kuzodingeka uyeke ukuthatha imithi ethile engandisa ingozi yokopha, okuhlanganisa i-aspirin, izinciphisi zegazi, kanye neminye imithi yokwelapha ngamakhambi. Ithimba lakho lezempilo lizokunikeza uhlu oluphelele lokuthi yini okufanele uyigweme nokuthi uyeke nini ukuthatha imithi ngayinye.

Ukuhlolwa kwangaphambi kokuhlinzwa kuvamile ukuhlanganisa ukuhlolwa kwegazi ukuze kuhlolwe amazinga akho e-hemoglobin kanye nesimo sempilo yakho esiphelele. Uma unegazi elincane ngenxa yokopha okukhulu, udokotela wakho angase ancome izithasiselo zensimbi noma ezinye izindlela zokwelapha ukuze uthuthukise ukubalwa kwegazi lakho ngaphambi kokuhlinzwa.

Ebusuku ngaphambi kokuhlinzwa, kuzodingeka uyeke ukudla nokuphuza ngesikhathi esithile, ngokuvamile cishe phakathi kwamabili. Ithimba lakho lokuhlinzwa lizokunikeza imiyalelo eqondile mayelana nokuthi uzoqala nini ukuzila ukudla kanye nanoma imiphi imithi okufanele uyithathe ekuseni ngosuku lokuhlinzwa.

Hlela isikhathi sakho sokululama ngokuhlela usizo ngemisebenzi yasekhaya, ukunakekelwa kwezingane, nezokuthutha. Gcina izingubo ezikhululekile, ukudla okunempilo, nanoma yiziphi izinto udokotela wakho azincomayo ngemva kokuhlinzwa.

Ungazifunda kanjani imiphumela yakho ye-myomectomy?

Ngemva kwe-myomectomy yakho, udokotela ohlinzayo uzonikeza imininingwane ngalokho okutholakele nokususwe ngesikhathi senqubo. Lolu lwazi lukusiza ukuthi uqonde izinga lenkinga yakho ye-fibroid nokuthi yini ongayilindela ekululameni.

Umbiko we-pathology uzoqinisekisa ukuthi izicubu ezisusiwe zazingempela ama-fibroids hhayi ezinye izinhlobo zokukhula. Lo mbiko ngokuvamile uthatha izinsuku eziningana ukuze uqedwe kodwa unikeza ukuqinisekiswa okubalulekile ngemvelo yesimo sakho.

Udokotela wakho ohlinzayo uzochaza usayizi, inombolo, nendawo yama-fibroids asusiwe. Lolu lwazi lusiza ukuqagela ukuthi ungahle uthole kangakanani ukukhululeka kwezimpawu nokuthi ngabe ukwelashwa okwengeziwe kungase kudingeke esikhathini esizayo.

Impumelelo yokululama ilinganiswa ngokuthuthuka kwezimpawu ezinyangeni ezilandelayo. Abesifazane abaningi baqaphela ukuncipha okukhulu kokopha okukhulu ngaphakathi kwemijikelezo yokuqala embalwa yokuya esikhathini ngemva kokuhlinzwa.

Ungakuthuthukisa kanjani ukululama kwakho ngemva kwe-myomectomy?

Ukwelulama ngemva kwe-myomectomy kudinga ukubekezela nokunaka ngokucophelela inqubo yokuphola yomzimba wakho. Isikhathi siyahluka ngokuya ngendlela yokuhlinza eyasetshenziswa kanye nekhono lakho lokuphola.

Ngezindlela ze-laparoscopic, abesifazane abaningi babuyela emisebenzini ejwayelekile phakathi kwamasonto amabili kuya kwamathathu. I-myomectomy evulekile ngokuvamile idinga amasonto amane kuya kwayisithupha esikhathini sokululama, enezithiyo zokuphakamisa kanye nokubuyela kancane kancane emsebenzini ogcwele.

Ukuphathwa kobuhlungu ngesikhathi sokululama kuvame ukubandakanya imithi kadokotela ezinsukwini ezimbalwa zokuqala, kulandelwe izinketho ezingaphezu kwe-counter njengoba ukungakhululeki kwehla. Ithimba lakho lokuhlinza lizohlinzeka ngemihlahlandlela ethile yokuphatha ubuhlungu ngokuphepha nangempumelelo.

Ukuqokwa okulandelayo kubalulekile ekuqapheni inqubekela phambili yakho yokuphola nokubhekana nanoma yiziphi izinkathazo. Udokotela wakho uzohlola izindawo zakho zokuhlinzwa, axoxe ngomuzwa wakho wokululama, futhi anqume ukuthi ungaqala nini kabusha imisebenzi ejwayelekile ehlanganisa ukuzivocavoca kanye nomsebenzi wezocansi.

Yiziphi izici eziyingozi zokudinga i-myomectomy?

Izici eziningana zikhuphula amathuba akho okuthuthukisa ama-fibroids abucayi ngokwanele ukudinga i-myomectomy. Ubudala budlala indima ebalulekile, ngama-fibroids avame kakhulu ukuthinta abesifazane abaneminyaka yobudala engama-30 nama-40.

Umlando womndeni unethonya elikhulu ekuthuthukisweni kwama-fibroid. Uma umama wakho noma odadewenu beke baba nama-fibroids, maningi amathuba okuthi nawe uwathuthukise. Le ngxenye yofuzo ayikwazi ukushintshwa kodwa isiza ukuchaza ukuthi kungani abanye besifazane bethambekele kakhulu.

Uhlanga nobuzwe kuthinta ingozi ye-fibroid, nabesifazane base-Afrika-America behlangabezana namanani aphezulu ama-fibroids nezimpawu ezinzima kakhulu. Lawa ma-fibroids athambekele ekuthuthukeni eminyakeni emincane futhi akhule abe makhulu kunezinye izakhamuzi.

Izici zokuphila ezingase zikhuphule ingozi ye-fibroid zihlanganisa ukukhuluphala, umfutho wegazi ophezulu, kanye nokudla okunama-fruit and vegetables amancane. Kodwa-ke, lezi zici azibikezeli kangako kunofuzo kanye nemininingwane yabantu.

Ukuya esikhathini ngaphambi kweminyaka eyi-12 (ngaphambi kweminyaka eyi-12) nokungakaze ukhulelwe nakho kuhlobene nengozi enkulu ye-fibroid. Izici ze-hormonal kuyo yonke iminyaka yakho yokuzala zithonya ukukhula kwe-fibroid nobukhulu bezimpawu.

Ziyini izinkinga ezingenzeka ze-myomectomy?

Njenganoma iyiphi inqubo yokuhlinzwa, i-myomectomy inezingozi ezithile okufanele uziqonde ngaphambi kokwenza isinqumo sakho. Abesifazane abaningi bathola ukululama okubushelelezi, kodwa ukuqaphela izinkinga ezingaba khona kukusiza ukuthi wenze ukukhetha okwazisiwe.

Ukuphuma igazi ngesikhathi noma ngemva kokuhlinzwa yikho okukhathaza kakhulu nge-myomectomy. Ukuphuma igazi okuningi ngesikhathi senqubo ngezinye izikhathi kudinga ukumpontshelwa igazi, nakuba lokhu kwenzeka ezingeni elingaphansi kuka-1% wamacala. Ukuphuma igazi ngemva kokuhlinzwa kuvame ukulawuleka ngokunakekela okufanele.

Ukunyuka kwamagciwane kungase kwenzeke ezindaweni zokuhlinza noma ngaphakathi emgodini wesisu, nakuba lokhu kungavamile uma kusetshenziswa indlela yokuhlinza efanele nokunakekelwa ngemva kokuhlinzwa. Izimpawu zokutheleleka zihlanganisa umkhuhlane, ubuhlungu obukhulu, noma ukukhishwa okungavamile ezindaweni zokuhlinza.

Ukwakheka kwezicubu ezilimele ngaphakathi emgodini wesisu noma esibelethweni kungase kuthinte ukuzala esikhathini esizayo, nakuba le ngozi ivamise ukuba phansi. Udokotela ohlinzayo uthatha izinyathelo zokunciphisa ukulimala, kodwa izinga elithile lokuphulukisa kwangaphakathi livame ukwenzeka ngemva kokuhlinzwa.

Izinkinga ezingavamile zihlanganisa ukulimala kwezitho eziseduze njengomchamo noma amathumbu, ikakhulukazi ngesikhathi sezinqubo eziyinkimbinkimbi ezihilela ama-fibroids amakhulu noma amaningi. Lezi zinkinga zenzeka ezingeni elingaphansi kuka-1% wezinqubo ze-myomectomy.

Abanye besifazane bathola izinguquko zesikhashana emaphethini okuya esikhathini noma ekuzaleni ngemva kwe-myomectomy, nakuba lezi zivame ukuxazululwa ezinyangeni ezimbalwa njengoba ukuphulukisa kuqhubeka.

Kufanele ngibone nini udokotela ngemva kwe-myomectomy?

Ukwazi ukuthi ungaxhumana nini nomhlinzeki wakho wokunakekelwa kwezempilo ngemva kwe-myomectomy kungasiza ekuqinisekiseni ukuphulukiswa okufanele nokubamba noma yiziphi izinkinga kusenesikhathi. Izinkinga eziningi ngemva kokuhlinzwa ziyingxenye ejwayelekile yokululama, kodwa ezinye izimpawu zidinga ukunakwa okusheshayo.

Xhumana nodokotela wakho ngokushesha uma uba nokopha okukhulu okugcwalisa iphedi njalo ngehora amahora amaningi. Ukopha okuthile kuvamile ngemva kokuhlinzwa, kodwa ukopha okukhulu kungase kubonise inkinga edinga ukwelashwa.

Umkhuhlane ongaphezu kuka-101°F (38.3°C) noma amahlaba angabonisa ukutheleleka futhi kufanele kubikwe eqenjini lakho lokuhlinzwa ngokushesha. Ukwelashwa ngokushesha kokutheleleka ngemva kokuhlinzwa kuholela emiphumeleni engcono nasekululameni okusheshayo.

Ubuhlungu obukhulu noma obuqhubekayo obungathuthuki ngemithi enikeziwe bungase bubonise izinkinga ezinjengokutheleleka noma ukopha kwangaphakathi. Unganqikazi ukushaya ucingo uma ubuhlungu buba nzima ukubhekana nabo noma buqhubeka ngokuphawulekayo.

Izimpawu zokutheleleka ezindaweni zokuhlinzwa zihlanganisa ukubomvu okwandayo, ukufudumala, ukuvuvukala, noma ukukhishwa okufana namathumba. Lezi zimpawu zidinga ukuhlolwa kwezokwelapha ngokushesha nokwelashwa ngama-antibiotic okungenzeka.

Ubunzima bokuchama, isicanucanu esiqhubekayo nokuhlanza, noma ukuphefumula ngokushesha kungazelelwe nakho kuyizizathu zokuxhumana nomhlinzeki wakho wezempilo ngokushesha ngemva kwe-myomectomy.

Imibuzo evame ukubuzwa mayelana ne-myomectomy

Q.1 Ingabe i-myomectomy iyasebenza ekopheni okukhulu kwesikhathi?

Yebo, i-myomectomy iyasebenza kakhulu ekunciphiseni ukopha okukhulu kwesikhathi okubangelwa ama-fibroids. Abesifazane abaningi bathola ukuthuthuka okukhulu emaphethini abo okopha phakathi nemijikelezo yokuqala embalwa yokuya esikhathini ngemva kokuhlinzwa.

Ucwaningo lubonisa ukuthi ama-80-90% abesifazane babika ukuncipha okukhulu ekopheni okukhulu ngemva kwe-myomectomy. Ukuthuthuka okuqondile kuncike ngosayizi, inombolo, nendawo yama-fibroids asuswe ngesikhathi senqubo yakho.

Q.2 Ngingakhulelwa ngemva kwe-myomectomy?

Abesifazane abaningi bangakhulelwa futhi bathwale ukukhulelwa okunempilo ngemva kwe-myomectomy, nakuba uzodinga ukulinda izinyanga eziningana ukuze ululame ngokuphelele. Udokotela wakho ngokuvamile uzoncoma ukulinda izinyanga ezintathu kuya kweziyisithupha ngaphambi kokuzama ukukhulelwa.

Amanani okuphumelela kokukhulelwa ngemva kwe-myomectomy ngokuvamile alungile, nabesifazane abaningi befinyelela usayizi womndeni abawufunayo. Nokho, ungase udinge ukulethwa nge-cesarean kuye ngohlobo lwe-myomectomy olwenziwe kanye nendlela isibeletho sakho eselapheke ngayo.

Q.3 Ingabe ama-fibroids azobuya ngemva kwe-myomectomy?

Ama-Fibroids angase akhule futhi ngemva kwe-myomectomy ngoba le nqubo ayishintshi izinto eziyisisekelo ezaziwabangela ekuqaleni. Nokho, amazinga okuphindeka ahlukahluka kakhulu kuye ngezimo zomuntu ngamunye.

Cishe ama-15-30% abesifazane bangase bathuthukise ama-fibroids amasha adinga ukwelashwa phakathi kweminyaka emi-5-10 ngemva kwe-myomectomy. Abesifazane abasebancane ngesikhathi sokuhlinzwa banamazinga aphakeme okuphindeka ngoba baneminyaka eminingi yokuchayeka kwamahomoni phambi kwabo.

Q.4 Kuthatha isikhathi esingakanani ukululama ku-myomectomy?

Isikhathi sokululama sincike ohlotsheni lwe-myomectomy obunalo kanye nenqubo yakho yokwelapha. Izinqubo ze-Laparoscopic ngokuvamile zidinga amasonto ama-2-3 ukuze kululame ekuqaleni, kuyilapho izinqubo ezivulekile zingathatha amasonto ama-4-6.

Ungalindela ukubuyela emsebenzini wedeskini phakathi kwamasonto ama-1-2 ezinqubweni ezingahlaseli kakhulu kanye namasonto ama-2-4 ngemva kokuhlinzwa okuvulekile. Ukululama okuphelele okuhlanganisa ukubuyela ekuzivoceni nasekuphakamiseni okunzima kuvame ukuthatha amasonto ama-6-8 kungakhathaliseki indlela esetshenzisiwe.

Q.5 Ziyini ezinye izindlela ezingathatha indawo ye-myomectomy?

Kunezindlela eziningana ezingathatha indawo yayo kuye ngezimpawu zakho, iminyaka yakho, kanye nemigomo yokuhlela umndeni. Ukwelashwa ngamahomoni njengamaphilisi okulawula ukuzala noma ama-IUD angasiza ekuphatheni izimpawu ngaphandle kokuhlinzwa kwabesifazane abathile.

Izinqubo ezingahlaseli kakhulu zihlanganisa i-uterine artery embolization, i-ultrasound egxilile, noma i-radiofrequency ablation. Kwabesifazane abangafuni ukukhulelwa esikhathini esizayo, i-hysterectomy inikeza ukwelashwa okuqinisekile ngokususa lonke isibeletho.