Yini i-TUIP? Inhloso, Inqubo & Nemiphumela

I-TUIP imele i-Transurethral Incision of the Prostate, inqubo yokuhlinzwa encane esiza amadoda anezimpawu ze-prostate enwetshiwe. Ngokungafani nokuhlinzwa kwe-prostate okukhulu, i-TUIP ihlanganisa ukwenza ukusikeka okuncane, okunembile ku-prostate ukuze kukhululwe ingcindezi ku-urethra. Le nqubo isebenza ikakhulu emadodeni anama-prostate amancane abhekana nezimpawu zomchamo eziphazamisayo kodwa afuna ukugwema ukwelashwa okuningi okuhlaselayo.

Yini i-TUIP?

I-TUIP iyindlela yokuhlinzwa lapho udokotela wakho we-urologist enza khona ukusikeka okukodwa noma okubili okuncane eglandeni lakho le-prostate ukuze kuthuthukiswe ukugeleza komchamo. Cabanga ngayo njengokudala ukuvuleka okuncane entanyeni eqinile ukuze kube lula ukuphefumula. Le nqubo iqondise endaweni lapho i-prostate yakho igqamuka khona i-urethra yakho, ithubhu elithwala umchamo usuka esinyeni sakho.

Ngesikhathi se-TUIP, udokotela ohlinzayo usebenzisa ithuluzi elincane, elikhanyisiwe elibizwa nge-cystoscope elifakwa nge-urethra yakho. Akukho ukusikeka kwangaphandle okudingekayo, okusho ukuthi ngeke ube nokusikeka okubonakalayo emzimbeni wakho. Yonke inqubo ngokuvamile ithatha imizuzu engama-20 kuya kwengama-30 futhi yenziwa ngaphansi kwe-anesthesia.

Le ndlela yenzelwe ngokuqondile amadoda anama-prostate angama-30 amagremu noma amancane ngosayizi. Ithathwa njengendawo emaphakathi phakathi kokuphathwa kwemithi nezinqubo eziningi ezifana ne-TURP (Transurethral Resection of the Prostate).

Kungani i-TUIP yenziwa?

I-TUIP incomwa uma i-prostate yakho enwetshiwe ibangela izimpawu zomchamo eziphazamisayo ezingathuthukanga ngemithi. Udokotela wakho angase asikisela le nqubo uma uhlangabezana nobunzima bokuqala ukuchama, ukugeleza komchamo okubuthakathaka, noma ukuvakashela igumbi lokugezela ebusuku njalo okuthinta izinga lempilo yakho.

Inhloso enkulu ukukhulula ingcindezi i-prostate yakho eyibeka ku-urethra yakho ngaphandle kokususa izicubu ze-prostate. Le ndlela igcina kakhulu i-anatomy yakho yemvelo uma iqhathaniswa nokunye ukuhlinzwa kwe-prostate. Ungase ube ngumuntu ofanelekayo uma une-prostate encane kodwa usazwa izimpawu ezibalulekile.

Udokotela wakho we-urologist uzocabangela i-TUIP uma ungenakukwazi ukubekezelela imithi ye-prostate ngenxa yemiphumela emibi, noma uma imithi ingazange inikeze ukukhululeka okwanele ngemva kwezinyanga eziningana zokwelashwa. Le nqubo ilungele ikakhulukazi amadoda amancane afuna ukugcina umsebenzi wabo wezocansi kanye nekhono lokukhipha amanzi ocansi.

Yini inqubo ye-TUIP?

Inqubo yakho ye-TUIP iqala ngokuphathwa kwe-anesthesia, kungaba i-spinal noma ejwayelekile, kuye ngesimo sakho sempilo kanye nokukhetha kwakho. Uma usuthuthukile, udokotela ohlinzayo ukubeka ngomhlane wakho ngemilenze yakho isekelwe kuma-stirrups, okufana nezinye izinqubo ze-urological.

Udokotela ohlinzayo ufaka i-cystoscope nge-urethra yakho futhi ayiqondise endaweni yakho ye-prostate. Le nsiza inokukhanya nekhamera evumela udokotela wakho ukuthi abone ngaphakathi komgudu wakho womchamo ngokucacile. Akukho ukusikeka kwangaphandle okwenziwayo noma yikuphi emzimbeni wakho ngesikhathi sale nqubo.

Esebenzisa ithuluzi lokusika ngogesi elinamathiselwe ku-cystoscope, udokotela wakho ohlinzayo wenza ukusikeka okukodwa noma okubili okunembile ku-prostate yakho. Lokhu kusikeka kuvame ukwenziwa ezindaweni zika-5 o'clock no-7 o'clock uma ucabanga i-prostate yakho njengobuso bewashi. Ukusikeka kunwetshwa kusuka entanyeni yesinye sakho kuya endaweni ngaphambi nje kwe-sphincter yakho yangaphandle yomchamo.

Ngemva kokwenza ukusikeka, udokotela wakho ohlinzayo angase asebenzise ugesi ukuvala noma yimiphi imithambo yegazi egelezayo. I-catheter bese ifakwa nge-urethra yakho ingene esinyeni sakho ukusiza ukukhipha umchamo ngenkathi i-prostate yakho iphiliswa. Yonke inqubo ngokuvamile ithatha imizuzu engu-20 kuya kwengu-30 ukuqedela.

Ungalungiselela kanjani i-TUIP yakho?

Ukulungiselela kwakho kuqala cishe ngesonto ngaphambi kokuhlinzwa lapho uzodinga ukuyeka ukuthatha imithi ethile engandisa ingozi yokopha. Lokhu kufaka phakathi izinciphisi zegazi ezinjenge-warfarin, i-aspirin, nezinye izithasiselo zemvelo. Udokotela wakho uzohlinzeka ngohlu oluqondile lwemithi okufanele uyigweme nokuthi uyeke nini ukuyithatha ngokuphepha.

Uzothola imiyalelo mayelana nokudla nokuphuza ngaphambi kokuhlinzwa, ngokuvamile okudinga ukuthi uzile ukudla amahora angu-8 kuya kwangu-12 ngaphambi kwalokho. Lokhu kuqapha kusiza ekuvimbeleni izinkinga ngesikhathi sokubeletwa. Ithimba lakho lezokwelapha lizokunikeza izikhathi ezithile zokuthi uyeke nini ukudla ukudla okuqinile nokuthi uyeke nini ukuphuza uketshezi olucacile.

Lungiselela othile ukuthi akuqhubele ekhaya ngemuva kwenqubo ngoba usazoqhubeka nokululama ekubelethweni. Uzophinda ufune ukulungiselela ikhaya lakho ukululama ngokuba nezihlalo ezinethezekile, ukudla okulula ukukulungisa, kanye nemithi ebekiwe etholakalayo kalula.

Udokotela wakho angase ancome ukuyeka izithasiselo ezithile ezinjengovithamini E, i-ginkgo biloba, noma amaphilisi kagalikhi angathinta ukujiya kwegazi. Uma uthatha imithi yezinye izimo, buza udokotela wakho ukuthi yiziphi okufanele uqhubeke nokuzithatha ekuseni ngosuku lokuhlinzwa.

Ungawafunda kanjani imiphumela yakho ye-TUIP?

Imiphumela yakho ye-TUIP ilinganiswa ikakhulukazi ngokuthuthuka kwezimpawu zakho zomchamo kunamanani elebhu. Impumelelo ngokuvamile ihlolwa ngemibuzo yezimpawu ezinjenge-International Prostate Symptom Score (IPSS) ozoyigcwalisa ngaphambi nangemva kokuhlinzwa.

Udokotela wakho uzohlola ukuthuthuka ezindaweni eziningana ezibalulekile: ukuthi uqala kalula kangakanani ukuchama, amandla omchamo wakho, ukuthi uwukhipha ngokuphelele kangakanani umchamo wakho, nokuthi udinga kangaki ukuchama emini nasebusuku. Amadoda amaningi aqaphela ukuthuthuka phakathi kwamasonto angu-2 kuya kwangu-6 ngemuva kokuhlinzwa.

Izilinganiso eziqondile zihlanganisa izivivinyo zesivinini sokugeleza komchamo, lapho uchamela khona kudivayisi ekhethekile elinganisa ukuthi umchamo uphuma ngokushesha kangakanani esinyeni sakho. Isivinini esijwayelekile sokugeleza ngokuvamile singama-milliliters ayi-15 ngomzuzwana noma ngaphezulu. Udokotela wakho angase futhi asebenzise i-ultrasound ukuhlola ukuthi umchamo ongakanani osele esinyeni sakho ngemva kokuchama.

Amazinga empumelelo yesikhathi eside ye-TUIP abonisa ukuthi cishe ama-80% amadoda athola ukuthuthuka okukhulu kwezimpawu ehlala iminyaka eminingana. Nokho, amanye amadoda angase adinge ukwelashwa okwengeziwe uma i-prostate yawo iqhubeka nokukhula ngokuhamba kwesikhathi.

Ungayiphatha kanjani ukululama kwakho ngemva kwe-TUIP?

Ukwelulama kwakho ngokushesha kuqala esibhedlela lapho uzohlala khona izinsuku eziyi-1 kuya kwezi-2 nge-catheter yomchamo endaweni. I-catheter isiza ukukhipha isinye sakho ngenkathi i-prostate yakho iphola futhi inciphisa ingozi yokugcinwa komchamo. Ungase uqaphele igazi elithile emchamweni wakho ekuqaleni, okujwayelekile ngokuphelele.

Uma usendlini, uzodinga ukuphuza amanzi amaningi ukuze usize ukukhipha uhlelo lwakho lomchamo futhi uvimbele ukutheleleka. Hlela izingilazi zamanzi eziyi-8 kuya kweziyi-10 nsuku zonke ngaphandle uma udokotela wakho ekweluleka ngenye indlela. Gwema utshwala ne-caffeine ekuqaleni, ngoba lokhu kungacasula izicubu zakho eziphilayo.

Umsebenzi womzimba kufanele ukhawulwe emasontweni ambalwa okuqala ngemva kokuhlinzwa. Gwema ukuphakamisa izinto ezisindayo (ezingaphezu kwamaphawundi ayi-10), ukuzivocavoca ngamandla, nokuzama ngesikhathi sokuhamba kwamathumbu. Le misebenzi ingakhuphula ingcindezi esiswini sakho futhi ingase ibangele ukopha.

Ungalindela ukubuyela emisebenzini ejwayelekile kancane kancane phakathi kwamasonto ama-2 kuya kwama-4. Amadoda amaningi angabuyela emsebenzini wedesk ngaphakathi kwezinsuku ezimbalwa, kuyilapho labo abanemisebenzi edinga umzimba bangase badinge amasonto ama-2 kuya kwama-3 bekhululiwe. Udokotela wakho uzohlinzeka ngemihlahlandlela ethile esekelwe ekuqhubekeni kwakho kokuphola.

Yiziphi izici eziyingozi zezinkinga ze-TUIP?

Ezinye izimo zezempilo zingakhuphula ingozi yakho yezinkinga ngesikhathi noma ngemva kwe-TUIP. Amadoda anesifo sikashukela esingalawuleki abhekana nezingozi eziphakeme zokutheleleka nokuphola kancane. Uma unesifo sikashukela, udokotela wakho uzofuna amazinga kashukela egazini lakho alawulwe kahle ngaphambi kokuhlinzwa.

Izimo zenhliziyo kanye nezinkinga zokuqina kwegazi zidinga ukunakwa okukhethekile ngesikhathi sokuhlela i-TUIP. Uma usebenzisa izinciphisi zegazi ngenxa yezinkinga zenhliziyo noma unomlando wokopha, ithimba lakho lokuhlinza lizodinga ukuphatha lezi zinto ngokucophelela. Udokotela wakho wenhliziyo kanye nodokotela wezifo zokuzala bazosebenzisana ukuqinisekisa ukuphepha kwakho.

Ubudala bodwa abuyona into evimbela i-TUIP, kodwa amadoda amadala angase abe nezimo zezempilo eziningi ezidinga ukucatshangelwa. Amadoda angaphezu kweminyaka engama-75 angase abe nezikhathi zokululama ezinde kanye nezingozi eziphakeme kancane zezinkinga ezinjengokugcinwa komchamo noma ukutheleleka.

Usayizi we-prostate ubaluleke kakhulu empumelelweni ye-TUIP. Amadoda anama-prostate amakhulu kakhulu (angaphezu kwama-30 amagremu) ngokuvamile awabona abaqokelwe kahle ngoba inqubo ingase inganikezi ukukhululeka okwanele. Udokotela wakho uzokala usayizi we-prostate yakho esebenzisa i-ultrasound noma i-MRI ngaphambi kokuncoma i-TUIP.

Ziyini izinkinga ezingaba khona ze-TUIP?

Izinkinga ezivamile ngemva kwe-TUIP ngokuvamile zithambile futhi zesikhashana. Ungase uzwe ukushisa ngesikhathi sokuchama izinsuku ezimbalwa, okuvame ukuxazululwa njengoba izicubu zakho ziphola. Amanye amadoda aqaphela amanani amancane egazi emchameni wawo kuze kube amasonto amabili ngemva kokuhlinzwa.

Ukutheleleka ngamathumbu omchamo kwenzeka cishe kuma-5% kuya kuma-10% amadoda ngemva kwe-TUIP. Izimpawu zihlanganisa ukushisa ngesikhathi sokuchama, ukuchama njalo, umchamo onamafu, noma umkhuhlane. Lokhu kutheleleka ngokuvamile kuphendula kahle ekwelashweni ngama-antibiotic futhi ngokuvamile akubangeli izinkinga zesikhathi eside.

Ushintsho ekusebenzeni ngokocansi alivamile nge-TUIP uma kuqhathaniswa nezinye izinqubo ze-prostate. Amadoda amaningi agcina ikhono lawo lokuba nokwakhiwa kanye nokuqeda. Nokho, amanye amadoda angase abe nokuchithwa kwamanzi emuva, lapho amanzi ocansi egelezela emuva angene esinyeni esikhundleni sokuphuma nge-penis ngesikhathi sokuqeda.

Izinkinga ezingavamile kodwa ezinzima zihlanganisa ukopha okukhulu okudinga ukumpontshwa kwegazi, okwenzeka ezingaphansi kuka-1% wamacala. Amanye amadoda angase abe nokungakwazi okwesikhashana ukuchama ngemuva kokususwa kwe-catheter, okudinga ukufakwa kabusha kwe-catheter izinsuku ezimbalwa ezengeziwe. Ngokungavamile, ukusikeka kungase kungelaphi kahle, okudinga ukwelashwa okwengeziwe.

Kufanele ngibone nini udokotela ngemuva kwe-TUIP?

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nokopha okukhulu ngamaqhubu amakhulu, ubuhlungu obukhulu obungakhululwa ngemithi ebekiwe, noma izimpawu zokutheleleka njengomkhuhlane ongaphezu kuka-101°F (38.3°C). Lezi zimpawu zingase zibonise izinkinga ezidinga ukunakekelwa kwezokwelapha okusheshayo.

Kufanele futhi ushayele udokotela wakho uma ungakwazi ukuchama ngemuva kokususwa kwe-catheter yakho, noma uma unesiyezi esiqhubekayo nokuhlanza okukuvimbela ukuthi uhlale unamanzi. Lezi zimo zingase zidinge ukufakwa kwe-catheter okwesikhashana noma ezinye izindlela zokungenelela.

Hlela i-aphoyintimenti yokulandela uma uqaphela ukuthi izimpawu zakho zomchamo azithuthukanga ngemuva kwamasonto angu-6 kuya kwangu-8 okuphulukisa. Ngenkathi amanye amadoda ebona ukuthuthuka ngokushesha, amanye adinga isikhathi esiningi ukuze athole izinzuzo ezigcwele zenqubo.

Qaphela izimpawu zokutheleleka ngamathumbu omchamo, okuhlanganisa ukusha ngesikhathi sokuchama, umchamo onamafu noma onukayo, noma ukwanda kwemvamisa yokuchama. Ukwelashwa ngokushesha kokutheleleka kusiza ekuvikeleni izinkinga ezingathi sína futhi kukhuthaza ukuphulukisa okungcono.

Imibuzo evame ukubuzwa mayelana ne-TUIP

Umbuzo 1: Ingabe i-TUIP ingcono kunemithi ye-prostate enwetshiwe?

I-TUIP nemithi zisebenzela izinjongo ezihlukene ekwelapheni izimpawu ze-prostate enwebile. Imithi efana nama-alpha-blockers kanye nama-5-alpha reductase inhibitors isebenza kahle kumadoda amaningi futhi ngokuvamile izanywa kuqala. Nokho, i-TUIP iba yindlela engcono uma imithi inganikezi ukukhululeka okwanele, idale imiphumela engamukeleki, noma uma ukhetha ukwelashwa okuqinisekile.

Inzuzo ye-TUIP ukuthi inikeza ukukhululeka okuhlala isikhathi eside ngaphandle kwesidingo semithi yansuku zonke. Amadoda amaningi athola ukuthuthuka okukhulu okuhlala iminyaka eminingi. Nokho, imithi ayihlaseli kangako futhi ayithwali izingozi zokuhlinzwa, okwenza ifaneleke amadoda anezimpawu ezithambile noma labo abangewona abazongenela ukuhlinzwa.

Umbuzo 2: Ingabe i-TUIP ithinta ukusebenza ngokocansi?

I-TUIP ngokuvamile inethonya elincane ekusebenzeni ngokocansi uma kuqhathaniswa nezinye izinqubo ze-prostate. Amadoda amaningi agcina ikhono lawo lokuba nokwakhiwa futhi athole ama-orgasm ngemuva kwe-TUIP. Le nqubo yenzelwe ngokuqondile ukugcina imizwa nezakhiwo ezibalulekile ekusebenzeni ngokocansi.

Amanye amadoda angase abe nokukhipha isidoda emuva, lapho isidoda sigeleza emuva singene esinyeni ngesikhathi se-orgasm esikhundleni sokuphuma ngomthondo. Lokhu akuthinti umuzwa we-orgasm noma ikhono lakho lokuba nokwakhiwa, kodwa kungathinta inzalo njengoba kukhishwa isidoda esincane.

Umbuzo 3: Ingabe ukukhululeka kwe-TUIP kuhlala isikhathi esingakanani?

I-TUIP inikeza ukukhululeka kwezimpawu okuhlala isikhathi eside kumadoda amaningi, ngocwaningo olukhombisa imiphumela emihle ehlala iminyaka engu-5 kuya ku-10 noma ngaphezulu. Cishe u-80% wamadoda athola ukuthuthuka okukhulu okugcinwa ngokuhamba kwesikhathi. Nokho, njengoba i-prostate ingaqhubeka nokukhula phakathi nempilo yendoda, ezinye izimpawu zingase zibuye kancane kancane.

Ubude bokukhululeka buxhomeke kancane eminyakeni yakho, impilo yonke, nokuthi i-prostate yakho ikhula kangakanani ngokuhamba kwesikhathi. Amadoda amancane angase athole izinzuzo ezihlala isikhathi eside, kuyilapho amadoda amadala angase adinge ukwelashwa okwengeziwe ngokushesha ngenxa yokuqhubeka kokukhula kwe-prostate.

Umbuzo 4: Ingabe i-TUIP ingaphindwa uma izimpawu zibuyela?

Yebo, i-TUIP ingaphindwa uma izimpawu zakho zibuyela futhi usengumuntu ofanelekayo kulolu hlelo. Kodwa-ke, izinqubo ze-TUIP eziphindwayo azivamile njengakwezinye izindlela zokwelapha i-prostate. Uma izimpawu zibuyela ngokuphawulekayo, udokotela wakho angase ancome ezinye izindlela zokwelapha ezifana ne-TURP noma izinqubo ezintsha.

Isinqumo sokuphinda i-TUIP sincike ngosayizi we-prostate yakho, impilo yonke, kanye nezinga lokubuyela kwezimpawu. Udokotela wakho we-urologist uzohlola lezi zinto futhi axoxe ngezinketho ezingcono kakhulu zesimo sakho esithile.

Umbuzo 5: Ingabe i-TUIP ihlanganiswa ngumshuwalense?

Izinhlelo eziningi zomshuwalense wezempilo, okuhlanganisa i-Medicare, zihlanganisa i-TUIP uma idingeka ngokwezokwelapha ukwelapha izimpawu ze-prostate enwetshiwe. Kodwa-ke, izidingo zokuhlanganisa ziyahluka phakathi kwezinkampani zomshuwalense nezinhlelo. Ihhovisi likadokotela wakho ngokuvamile liphatha ukugunyazwa kwangaphambi komshuwalense ukuze kuqinisekiswe ukuthi inqubo ihlanganisiwe.

Uzofuna ukuxhumana nomhlinzeki wakho womshuwalense mayelana nemininingwane yakho ethile yokuhlanganisa, okuhlanganisa noma yiziphi izindleko zokukhipha, izinkokhelo ezihlanganyelwe, noma izindleko eziphuma ephaketheni. Ezinye izinhlelo zomshuwalense zingase zidinge ukuthi uzame ukwelashwa ngemithi kuqala ngaphambi kokugunyaza izinqubo zokuhlinzwa njenge-TUIP.