Yini i-Prostatectomy? Injongo, Inqubo & Ukululama

I-prostatectomy iyinqubo yokuhlinzwa yokususa yonke noma ingxenye yegland ye-prostate. Lokhu kwelashwa kuvame ukunconywa emadodeni anomdlavuza we-prostate, nakuba kungasiza futhi ezimweni ezinzima ze-prostate enwebekile engaphendulanga kwezinye izindlela zokwelapha.

I-prostate iyigland encane, enosayizi we-walnut ehlala ngaphansi kwesitho sakho somchamo futhi ezungeza i-urethra. Lapho umdlavuza uvela noma igland iba nkulu kakhulu, ukuyisusa ngokuhlinzwa kungaba yindlela ephumelela kakhulu yokuvikela impilo yakho nokuthuthukisa izinga lempilo yakho.

Yini i-prostatectomy?

I-Prostatectomy isho ukususa ngokuhlinzwa igland ye-prostate emzimbeni wakho. Kunezinhlobo ezimbili eziyinhloko: i-prostatectomy eqinile isusa yonke igland ye-prostate kanye nezinye izicubu ezizungezile, kuyilapho i-prostatectomy elula isusa kuphela ingxenye engaphakathi ye-prostate.

I-prostatectomy eqinile iyindlela yokwelapha ejwayelekile yomdlavuza we-prostate wendawo. Ngesikhathi sale nqubo, udokotela ohlinzayo wakho ususa yonke igland ye-prostate, ama-seminal vesicles (amasaka amancane akhiqiza uketshezi lwesidoda), futhi ngezinye izikhathi ama-lymph nodes aseduze ukuze ahlolisise ukusabalala komdlavuza.

I-prostatectomy elula ayivamile futhi ngokuvamile igcinelwe amadoda anama-prostate amakhulu kakhulu abangela izinkinga ezinzima zomchamo. Le ndlela isusa kuphela izicubu ezinwebekile ezivimbela ukugeleza komchamo, ishiya igobolondo elingaphandle le-prostate lingathintekile.

Kungani kwenziwa i-prostatectomy?

I-Prostatectomy yenziwa ikakhulukazi ukwelapha umdlavuza we-prostate ongakaze usabalale ngaphandle kwegland ye-prostate. Udokotela wakho angase ancome lokhu kuhlinzwa uma unomdlavuza wesigaba sokuqala futhi unempilo eyanele yokuhlinzwa okukhulu.

Umgomo oyinhloko uwukususa ngokuphelele umdlavuza emzimbeni wakho ngaphambi kokuba ube nethuba lokusabalala kwamanye amalungu omzimba. Lokhu kukunika ithuba elingcono kakhulu lokungabi nomdlavuza isikhathi eside, ikakhulukazi uma umdlavuza ubanjwe ekuqaleni futhi uvinjelwe ku-prostate.

Ngokuvamile, i-prostatectomy ingase incomwe ngenxa ye-benign prostatic hyperplasia (i-enlarged prostate) uma imithi kanye nokwelashwa okungahlaseli kangako kungazange kusize izimpawu zakho. Lesi simo ngokuvamile sihlanganisa amadoda anama-prostate amakhulu kakhulu abangela izinkinga ezinzima zomchamo noma ukulimala kwezinso.

Yini inqubo ye-prostatectomy?

Indlela yokuhlinza incike esimweni sakho esithile kanye nobuchwepheshe bomhlinzi wakho. Ama-prostatectomies amaningi namuhla enziwa kusetshenziswa izindlela ezingahlaseli kakhulu eziholela ekusikeni okuncane nezikhathi zokululama ezisheshayo.

I-Robot-assisted laparoscopic prostatectomy njengamanje iyindlela ejwayelekile kakhulu. Umhlinzi wakho usebenza ngokusebenzisa ukusikwa okuncane esebenzisa amathuluzi e-robotic ahlinzeka ngokunemba okuthuthukisiwe kanye nokubonwa kwe-3D. Le ndlela ngokuvamile iholela ekulahlekelweni igazi elincane, ukunciphisa ubuhlungu, nokuphulukisa ngokushesha uma kuqhathaniswa nokuhlinzwa okuvulekile kwendabuko.

Ngesikhathi senqubo, uzobe ungaphansi kwe-anesthesia ejwayelekile futhi ngeke uzizwe lutho. Umhlinzi wakho uhlukanisa ngokucophelela i-prostate ezakhiweni ezizungezile, okuhlanganisa isinye nomchamo, bese ekhipha i-gland ngokuphelele. Isinye bese sixhunywa emchameni.

I-Open radical prostatectomy ihlanganisa ukusikwa okukhulu esiswini sakho esingezansi. Nakuba kungavamile manje, le ndlela ingase idingeke kuma-prostate amakhulu kakhulu noma uma ukuhlinzwa kwangaphambilini kudalile izicubu ezinamanxeba ezenza izindlela ezingahlaseli kangako zibe yinselele.

Ungalungiselela kanjani i-prostatectomy yakho?

Ukulungiselela kwakho kuqala emasontweni ambalwa ngaphambi kokuhlinzwa ngokuhlolwa okubanzi nokuhlela. Ithimba lakho lezokwelapha lizoqinisekisa ukuthi unempilo eyanele yokuhlinzwa futhi lizokusiza ukuthi uqonde okulindeleke ngesikhathi sokululama.

Kuzodingeka ukuthi uyeke imithi ethile engandisa ingozi yokopha, njengemithi yokunciphisa igazi, i-aspirin, nezinye izithasiselo. Udokotela wakho uzokunika imiyalelo ethile mayelana nokuthi iyiphi imithi okufanele uyeke ukuyithatha nokuthi nini. Ungalokothi uyeke imithi ebekiwe ngaphandle kokubonisana neqembu lakho lezempilo kuqala.

Ukuhlolwa ngaphambi kokuhlinzwa kuvamile ukuhlanganisa ukuhlolwa kwegazi, izithombe zokuhlola, futhi ngezinye izikhathi ukuhlolwa okwengeziwe komsebenzi wenhliziyo noma wamaphaphu. Lokhu kusiza ithimba lakho lokuhlinzwa ukuthi lihlele indlela engcono kakhulu yokuhlinzwa ngokuya ngesimo sakho somzimba kanye nesimo sempilo.

Ngosuku olwandulela ukuhlinzwa, kuzodingeka ukuthi ulandele imikhawulo ekhethekile yokudla. Iziguli eziningi ziceliwe ukuthi zidle ukudla okulula kusihlwa ngaphambi kokuhlinzwa bese zigwema konke ukudla neziphuzo ngemuva kwamabili. Ukulungiswa kwamathumbu akho kungase kuhlanganise i-enema noma i-laxative ukuqinisekisa ukuthi amathumbu akho awalutho.

Ungazifunda kanjani imiphumela yakho ye-prostatectomy?

Umbiko wakho we-pathology unikeza imininingwane enemininingwane ngomdlavuza otholakala ku-prostate yakho esusiwe. Lo mbiko usiza ukunquma ukuthi ngabe ukwelashwa okwengeziwe kuyadingeka yini futhi unikeza ukuqonda ngombono wakho wesikhathi eside.

I-pathologist izohlola i-prostate yakho yonke ngaphansi kwe-microscope futhi ibike izinto ezimbalwa ezibalulekile ezitholakele. I-Gleason score ichaza ukuthi amaseli omdlavuza abukeka kanjani ngendluzula, ngamaphuzu aphansi abonisa umdlavuza okhula kancane. Amaphuzu asukela ku-6 kuya ku-10, lapho u-6 eyilowo ongahlasele kakhulu.

Imingcele yokuhlinzwa ikutshela ukuthi ngabe amaseli omdlavuza atholakala emaphethelweni ezicubu ezisusiwe. Imingcele ecacile isho ukuthi udokotela ohlinzayo ususe wonke umdlavuza obonakalayo, kanti imingcele emihle ingase ikhombe amaseli omdlavuza amancane asele futhi ukwelashwa okwengeziwe kungaba usizo.

Isigaba se-pathological sichaza ukuthi umdlavuza usabalale kangakanani ngaphakathi kwe-prostate nokuthi ngabe unwele ngaphandle kwegland. Lolu lwazi, oluhlanganiswe nokuhlolwa kwakho ngaphambi kokuhlinzwa, lusiza ithimba lakho lezokwelapha ukuthi linqume ukuthi ngabe udinga ukwelashwa okwengeziwe njengemisebe.

Ungayithuthukisa kanjani ukululama kwakho kwe-prostatectomy?

Ukwelulama ku-prostatectomy kuyinqubo kancane kancane evame ukuthatha amasonto amaningana kuya ezinyangeni. Ukulandela imiyalelo kadokotela ohlinzayo ngokucophelela kusiza ekuqinisekiseni umphumela ongcono kakhulu futhi kunciphisa ingozi yakho yezinkinga.

Ukuphathwa kobuhlungu kubalulekile ezinsukwini ezimbalwa zokuqala ngemva kokuhlinzwa. Ithimba lakho lezokwelapha lizohlinzeka ngemithi yokukugcina ukhululekile, futhi ubuhlungu buvame ukwehla kakhulu phakathi nesonto lokuqala. Iziguli eziningi zithola ukuthi izidambisi zokucasuka ezithengiswa ngaphandle kwemithi kadokotela zanele ngemva kwezinsuku ezimbalwa zokuqala.

Uzoba ne-catheter yomchamo cishe isonto elilodwa kuya kwamabili ngemva kokuhlinzwa. Le tube encane ikhipha umchamo esinyeni sakho ngenkathi ukuxhumana phakathi kwesinye sakho ne-urethra kuphola. Nakuba kungakhululeki, i-catheter ibalulekile ekupholiseni okufanele nasekuvikeleni izinkinga.

Ukuvinjelwa komsebenzi womzimba kusiza ukuvikela izicubu zakho eziphilayo. Kuzodingeka ukugwema ukuphakamisa izinto ezinzima, ukuzivocavoca okukhulu, nokushayela amasonto amaningana. Nokho, ukuhamba kancane kukhuthazwa kusukela ngosuku lokuqala ngemva kokuhlinzwa ukuvimbela amahlule egazi nokukhuthaza ukuphola.

Ziyini izici eziyingozi zezinkinga ze-prostatectomy?

Nakuba i-prostatectomy ngokuvamile iphephile, izici ezithile zingakhuphula ingozi yakho yezinkinga. Ukuqonda lokhu kukusiza wena nethimba lakho lezokwelapha ukuthi nithathe izinyathelo zokuphepha ezifanele futhi nenze izinqumo ezinolwazi mayelana nokunakekelwa kwakho.

Ubudala nesimo sempilo esiphelele kuthinta kakhulu ingozi yakho yokuhlinzwa. Amadoda angaphezu kweminyaka engama-70 noma labo abanezifo zenhliziyo, isifo sikashukela, noma ezinye izimo ezingapheli babhekana nezingozi eziphezulu zezinkinga. Nokho, amadoda amaningi amadala aphumelela i-prostatectomy enemiphumela emihle kakhulu.

Ukuhlinzwa kwesisu kwangaphambilini noma ukwelashwa ngemisebe kungenza inqubo ibe yinselele ngokwengeziwe ngokobuchwepheshe. Izicubu ezinamathiselwe ezivela ekwelashweni kwangaphambilini zingenza kube nzima kubahlinzi ukuthi bahlonze izindiza zezicubu ezivamile, okungenzeka ukuthi zikhuphule isikhathi sokusebenza nengozi yezinkinga.

Ubukhulu be-prostate nobukhulu bomdlavuza nakho kunomthelela emazingeni obungozi. Ama-prostate amakhulu kakhulu noma umdlavuza okhule eduze kwezakhiwo ezizungezile kungase kudingeke izindlela zokuhlinza eziyinkimbinkimbi, okungenzeka ukuthi zikhuphula ithuba lezinkinga.

Ukubhema nokukhuluphala kuyizinto eziyingozi ezingashintshwa ongazixazulula ngaphambi kokuhlinzwa. Ukubhema kuphazamisa ukuphola kwamanxeba futhi kwandisa ingozi yokutheleleka, kuyilapho isisindo esiningi singenza ukuhlinzwa kube nzima kakhulu ngokobuchwepheshe futhi kwehlise ukululama.

Ziyini izinkinga ezingase zibe khona ze-prostatectomy?

Njenganoma yikuphi ukuhlinzwa okukhulu, i-prostatectomy inezingozi ezingaba khona nezinkinga. Amadoda amaningi awabi nazinkinga ezinkulu, kodwa ukuqonda izinkinga ezingaba khona kukusiza ukuthi wenze izinqumo ezinolwazi futhi ubone ukuthi unini okufanele ufune ukwelashwa.

Izinkinga ezivame kakhulu zithinta ukusebenza komchamo nokocansi. Lezi zinkinga zivame ukuba zesikhashana kodwa ngezinye izikhathi zingaba unomphela, kuye ngezinto ezihlukahlukene ezihlanganisa iminyaka yakho, impilo yonke, nobukhulu bokuhlinzwa obudingekayo.

Nazi izinkinga eziyinhloko okufanele uziqaphele:

• Ukungakwazi ukuzibamba umchamo: Ukuba nobunzima bokulawula ukugeleza komchamo kuthinta amadoda amaningi ekuqaleni kodwa ngokuvamile kuthuthuka ngokuhamba kwesikhathi. Ukululama okuphelele kokulawula isinye kungathatha izinyanga eziningana kuya ngonyaka.
• Ukungasebenzi kahle kwe-erectile: Ukuba nobunzima bokuthola noma ukugcina ama-erection kuvamile ngemva kokuhlinzwa. Ukululama kuncike eminyakeni, ukusebenza ngaphambi kokuhlinzwa, nokuthi ngabe izindlela zokonga imizwa zazingenzeka yini.
• Ukuphuma igazi: Ukuphuma igazi okuthile kuvamile, kodwa ukuphuma igazi ngokweqile kungase kudingeke ukwelashwa okwengeziwe noma, ngokungavamile, ukumpontshelwa igazi.
• Ukutheleleka: Ukutheleleka kwendawo yokuhlinza noma ukutheleleka kwamathumbu omchamo kungenzeka kodwa ngokuvamile kulashwa ngama-antibiotics.
• Ukubunjwa kwe-stricture: Izicubu ezinamanxeba zinganciphisa ukuxhumana phakathi kwesinye nomgudu womchamo, okungenzeka kudingeke izinqubo ezengeziwe.

Izinkinga ezingathi sína kodwa ezingavamile zihlanganisa amahlule egazi, izinkinga zenhliziyo, noma ukulimala kwamathumbu. Ithimba lakho labahlinzi liqapha ngokucophelela lezi zinkinga futhi linemithetho yokuzisingatha uma zenzeka.

Kufanele ngibone nini udokotela ngemva kwe-prostatectomy?

Ukunakekelwa okuvamile kokulandela ngemva kwe-prostatectomy kubalulekile ukuqapha ukululama kwakho nokubheka noma yiziphi izimpawu zokubuyela emuva komdlavuza. Ithimba lakho lezokwelapha lizohlela ama-aphoyintimenti athile, kodwa kufanele futhi wazi ukuthi kufanele ufune nini ukunakekelwa kwezokwelapha ngokushesha.

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nobuhlungu obukhulu obungalawulwa yimithi enikeziwe, izimpawu zokutheleleka njengomkhuhlane noma ama-chills, noma ukuphuma kwegazi okukhulu. Lezi zimpawu zingabonisa izinkinga ezidinga ukwelashwa ngokushesha.

Izinkinga nge-catheter yakho yomchamo nazo zidinga ukunakwa ngokushesha. Uma i-catheter iyeka ukukhipha, ikhishwa, noma ibangela ubuhlungu obukhulu, xhumana nethimba lakho lezokwelapha ngokushesha. Ungazami ukulungisa izinkinga ze-catheter ngokwakho.

Ukwelashwa kwesikhathi eside ngokuvamile kufaka phakathi ukuhlolwa kwegazi kwe-PSA okuvamile ukuqapha ukubuyela emuva komdlavuza. Udokotela wakho uzohlola nokululama kwakho komsebenzi womchamo nowezocansi futhi anikeze ukwelashwa noma izinkomba uma kudingeka.

Imibuzo evame ukubuzwa mayelana ne-prostatectomy

Q.1 Ingabe i-prostatectomy ilungile kumdlavuza we-prostate esigabeni sokuqala?

Yebo, i-prostatectomy ithathwa njengenye yezindlela zokwelapha eziphumelela kakhulu kumdlavuza we-prostate esigabeni sokuqala. Uma umdlavuza uvinjelwe endleni ye-prostate, ukususwa ngokuhlinzwa kunikeza amazinga amahle okuphulukisa nemiphumela yokusinda yesikhathi eside.

Inzuzo enkulu ukususwa okuphelele komdlavuza, okuqeda ingozi yokuthi umdlavuza ukhule noma usabalale ku-prostate. Izifundo zibonisa ukuthi amadoda anomdlavuza we-prostate wendawo abhekene ne-prostatectomy anamazinga okusinda afana nalawo amadoda angenayo umdlavuza.

Q.2 Ingabe i-prostatectomy ibangela ukungakwazi ukuzibamba unomphela?

Amadoda amaningi abuyisa ukulawula umchamo ngemva kwe-prostatectomy, nakuba kuthatha isikhathi. Ukungakwazi ukuzibamba ngokuphelele akuvamile, kuthinta cishe ama-5-10% amadoda esikhathini eside. Iningi leziguli lithola ukulawula umchamo okwanelisayo phakathi nezinyanga eziyisithupha nonyaka.

Ukwelulama kuncike ezintweni eziningana ezihlanganisa iminyaka, ukusebenza komchamo ngaphambi kokuhlinzwa, kanye nezinqubo zokuhlinza. Ukuvivinya umzimba kwesifunda se-pelvic kanye neminye imithi kungasiza ukusheshisa ukululama futhi kuthuthukise imiphumela yamadoda amaningi.

Q.3 Ngizodinga yini ukwelashwa okwengeziwe komdlavuza ngemva kwe-prostatectomy?

Amadoda amaningi awadingi ukwelashwa okwengeziwe ngemva kwe-prostatectomy eyimpumelelo. Kodwa-ke, cishe ama-20-30% eziguli angazuza emithini yokwelapha ngemisebe uma imiphumela ye-pathology ikhombisa izici eziyingozi ephezulu njengemiphetho emihle noma ukwanda komdlavuza ngaphandle kwe-prostate.

Ithimba lakho lezokwelapha lizobukeza imiphumela yakho ye-pathology futhi lincomende ukwelashwa okwengeziwe kuphela uma kungenzeka ukuthi kuthuthukise imiphumela yakho yesikhathi eside. Ukuqapha njalo i-PSA kusiza ukuthola noma yiziphi izimpawu zokubuyela emuva komdlavuza ngokushesha.

Q.4 Kuthatha isikhathi esingakanani ukululama ku-prostatectomy?

Ukwelulama kokuqala kuthatha amasonto angaba ngu-4-6, lapho uzobuyela kancane kancane emisebenzini evamile. Kodwa-ke, ukululama okuphelele komsebenzi womchamo nowezocansi kungathatha izinyanga eziyi-6-12 noma ngaphezulu.

Amadoda amaningi abuyela emsebenzini phakathi kwamasonto angu-2-4, kuye ngezidingo zomsebenzi wawo. Ukuphakamisa izinto ezinzima nemisebenzi eqinile ngokuvamile kuvinjelwe amasonto angu-6-8 ukuze kuvumele ukuphulukiswa okufanele.

Q.5 Ingabe i-prostatectomy ingenziwa ngezindlela ezingahlaseli kakhulu?

Yebo, ama-prostatectomies amaningi namuhla enziwa kusetshenziswa izindlela ze-robotic noma ze-laparoscopic ezingahlaseli kakhulu. Lezi zindlela zinikeza izinzuzo eziningana ezihlanganisa ukusikeka okuncane, ukulahleka kwegazi elincane, ukunciphisa ubuhlungu, nokululama ngokushesha uma kuqhathaniswa nokuhlinzwa okuvulekile kwendabuko.

I-Robot-assisted prostatectomy isibe yindlela ejwayelekile kakhulu ngoba inikeza odokotela ukunemba okuthuthukisiwe kanye nokubona kwe-3D. Kodwa-ke, indlela engcono kakhulu yokuhlinza incike esimweni sakho esithile kanye nobungoti bomhlinzi wakho.