Yini i-TURP? Inhloso, Inqubo & Ukululama

I-TURP imele i-Transurethral Resection of the Prostate, inqubo ejwayelekile yokuhlinzwa esiza amadoda anezindlala ze-prostate ezikhulisiwe ukuba achame kalula. Ngesikhathi sokuhlinzwa okuncane, udokotela wakho wezifo zokuzala ususa izicubu ze-prostate ezingeziwe ezivimba ukugeleza komchamo wakho, njengokuthi ususa umgqomo ovimbekile ukuze ubuyisele ukugeleza kwamanzi okuvamile.

Yini i-TURP?

I-TURP iyinqubo yokuhlinzwa lapho udokotela wakho esusa izingxenye ze-prostate ekhulisiwe ngomgudu wakho womchamo ngaphandle kokwenza noma yikuphi ukusika kwangaphandle. Udokotela ohlinzayo usebenzisa ithuluzi elikhethekile elibizwa ngokuthi i-resectoscope, elidlula ngesitho sakho sangasese ukuze lifinyelele ku-prostate futhi linqume ngokucophelela izicubu ezingeziwe ezibangela izinkinga zomchamo.

Le nqubo yenziwe ngokuphepha amashumi eminyaka futhi isahlala ingenye yezindlela zokwelapha eziphumelela kakhulu ze-benign prostatic hyperplasia (BPH), okuyisikhuliso se-prostate esingeyona umdlavuza. Ngokungafani nokuhlinzwa okuvulekile, i-TURP ayidingi noma yikuphi ukusika esiswini sakho noma emathangeni, okwenza ukululama kuvame ukushesha futhi kungabi buhlungu.

Kungani kwenziwa i-TURP?

I-TURP ngokuvamile incomwa lapho i-prostate ekhulisiwe iphazamisa kakhulu impilo yakho yansuku zonke futhi ezinye izindlela zokwelapha azizange zinikeze ukukhululeka okwanele. Udokotela wakho angase asikisela le nqubo uma uhlangabezana nezimpawu zomchamo eziqhubekayo ezithinta izinga lempilo yakho noma ezibeka izingozi zempilo.

Izizathu ezivame kakhulu odokotela abancoma ngazo i-TURP zihlanganisa izinkinga eziningana zomchamo ezingase zivele ku-prostate ekhulisiwe:

• Ukungakwazi ukuchama ngokuphelele noma nakancane (ukugcinwa komchamo)
• Izifo zomgudu womchamo ezivame ukwenzeka ngenxa yokungapheleli komchamo
• Igazi emchameni wakho eliqhubekayo noma eliphindaphindayo
• Izinkinga zezinso ezibangelwa umchamo obuyayo
• Amatshe esinye esitholakala ngenxa yokungapheleli komchamo
• Ukuvuka ebusuku kaningi okukhulu okuphazamisa ukulala kwakho izikhathi eziningi
• Ukugeleza komchamo okubuthakathaka okwenza kube nzima ukukhipha umchamo wakho

Udokotela wakho wezifo zesisu uzobuye acabangele i-TURP uma imithi efana ne-alpha-blockers noma i-5-alpha reductase inhibitors ingazange ithuthukise izimpawu zakho ngemva kwezinyanga eziningana zokwelashwa. Ngezinye izikhathi, ngisho nalapho imithi isiza ekuqaleni, izimpawu zingase zibe zimbi ngokuhamba kwesikhathi njengoba i-prostate iqhubeka nokukhula.

Yini inqubo ye-TURP?

I-TURP yenziwa egumbini lokusebenzela esibhedlela ngaphansi kwe-anesthesia yomgogodla noma ejwayelekile, ngakho ngeke uzizwe unganethezekile ngesikhathi sokuhlinzwa. Yonke inqubo ngokuvamile ithatha phakathi kwemizuzu engama-60 kuya kwengama-90, kuye ngosayizi we-prostate yakho nokuthi ingakanani inyama okudingeka ikhishwe.

Nakhu okwenzekayo ngesikhathi senqubo yakho ye-TURP, isinyathelo ngesinyathelo:

1. Uzothola i-anesthesia ukuze uqinisekise ukuthi uzizwa ukhululekile ngokuphelele ngesikhathi sokuhlinzwa
2. Udokotela ohlinzayo ufaka i-resectoscope ngomgudu wakho womchamo ukuze afinyelele ku-prostate
3. Ithuluzi elikhethekile lokusika lisusa izingcezu ezincane zenyama ye-prostate ezivimba ukugeleza komchamo
4. Izingcezu zenyama ezisusiwe zigezwa ngaphandle nge-resectoscope
5. Udokotela wakho ohlinzayo uhlola ngokucophelela noma yikuphi ukopha futhi uvala imithambo yegazi njengoba kudingeka
6. I-catheter ifakwa esinyeni sakho ukusiza ngokuphola nokuqapha ukululama kwakho

Ukuhlinzwa kwenziwa ngokuphelele ngembobo yakho yemvelo yomchamo, ngakho-ke akukho ukusikeka kwangaphandle noma imithungo okufanele ukhathazeke ngayo. Udokotela ohlinzayo uzosusa kuphela ingxenye engaphakathi ye-prostate ebangela ukuvaleka, eshiye igobolondo langaphandle lingathintekile ukuze kugcinwe ukusebenza okuvamile.

Indlela yokulungiselela i-TURP yakho?

Ukulungiselela i-TURP kuhilela izinyathelo eziningana ezibalulekile ezisiza ukuqinisekisa ukuthi ukuhlinzwa kwakho kuhamba kahle futhi kunciphisa ingozi yezinkinga. Ithimba lakho lezempilo lizokuqondisa kuzo zonke izinyathelo zokulungiselela futhi liphendule noma yimiphi imibuzo ongase ube nayo mayelana nenqubo.

Udokotela wakho cishe uzokucela ukuthi uyeke imithi ethile ngaphambi kokuhlinzwa, ikakhulukazi lezo ezithinta ukujiya kwegazi:

• Izinciphisi zegazi ezinjenge-warfarin, ngokuvamile ziyekiswa izinsuku ezi-3-5 ngaphambi kokuhlinzwa
• I-Aspirin kanye nemithi elwa nokuvuvukala, ngokuvamile iyekiswa izinsuku eziyi-7-10 ngaphambi kokuhlinzwa
• Izithasiselo zemithi yama-herbal ezingase zithinte ukopha, njenge-ginkgo noma igalikhi
• Eminye imithi yesifo sikashukela engase idinge ukulungiswa

Uzodinga futhi ukuhlela ukuthi othile akuqhubele ekhaya ngemva kwenqubo ngoba i-anesthesia ithinta ukusabela kwakho nokwahlulela amahora amaningana. Hlela ukuthi umuntu omdala onomthwalo wemfanelo ahlale nawe okungenani amahora angama-24 okuqala ngemva kokuhlinzwa ukuze asize ngezidingo eziyisisekelo futhi aqaphe ukululama kwakho.

Ngobusuku obandulela ukuhlinzwa, uzodinga ukuzila ukudla okungenani amahora angu-8-12, okusho ukuthi akukho ukudla noma iziphuzo ngemva kwamabili noma isikhathi esishiwo yithimba lakho lokuhlinzwa. Lokhu kuqapha kuvimbela izinkinga ezivela ku-anesthesia futhi kuqinisekisa ukuthi isisu sakho sishintshile ngesikhathi senqubo.

Ungazifunda kanjani imiphumela yakho ye-TURP?

Imiphumela ye-TURP ngokuvamile ilinganiswa ngokuthi izimpawu zakho zomchamo zithuthuka kangakanani kunokuba ngamanani athile anjengokuhlolwa kwegazi. Udokotela wakho uzohlola inqubekela phambili yakho esebenzisa imibuzo yezimpawu kanye nezilinganiso eziqondile zokugeleza komchamo wakho nokusebenza kwesinye.

Amadoda amaningi aqaphela ukuthuthuka okukhulu ezimpawini zawo zomchamo emasontweni ambalwa okuqala ngemva kwe-TURP. Kufanele ulindele ukuthi umchamo wakho uqine, isinye sakho sikhishwe ngokuphelele, nokuchama ebusuku kunciphe kakhulu.

Udokotela wakho wezifo zokuzala uzolandela izinkomba ezimbalwa ezibalulekile ukuze ahlulele ukuthi i-TURP yakho isebenze kahle kangakanani:

• Ukwenziwa kwezilinganiso zokugeleza komchamo ngesikhathi sokuvakasha okulandelayo
• Ivolumu esele ngemva kokuchama (ukuthi kungakanani umchamo osele esinyeni sakho ngemva kokuchama)
• Amaphuzu obunzima bezimpawu zokusebenzisa imibuzo ejwayelekile
• Ukuthuthuka kwekhwalithi yempilo ekulaleni nasemisebenzini yansuku zonke
• Ukunciphisa ukuvama kokuchama, ikakhulukazi ebusuku

Izicubu ezisusiwe ngesikhathi se-TURP yakho zizothunyelwa elabhorethri ukuze zihlolwe ukuze kuqedwe umdlavuza, ngisho noma i-TURP yenziwa ikakhulukazi ngezimo ezingezona ezinobungozi. Udokotela wakho uzoxoxa ngemiphumela yale pathology nawe ngesikhathi sokuqokwa kwakho okulandelayo.

Ungayithuthukisa kanjani ukululama kwakho kwe-TURP?

Ukwelashwa kwe-TURP kuhilela ukulandela imihlahlandlela ethile esiza i-prostate yakho ukuthi iphole kahle futhi inciphise ingozi yezinkinga. Amadoda amaningi angabuyela emisebenzini elula ezinsukwini ezimbalwa, kodwa ukuphola okuphelele kuvame ukuthatha amasonto angu-4-6.

Ngesikhathi sokululama kwakho kokuqala, uzoba ne-catheter endaweni izinsuku ezingu-1-3 ukusiza isinye sakho ukuthi sikhiphe ngenkathi ukuvuvukala kuncipha. Le catheter yesikhashana ivimbela ukugcinwa komchamo futhi ivumela udokotela wakho ukuthi aqaphele ukuqhubeka kwakho kokuphola ngombala nokucaca komchamo wakho.

Nansi imihlahlandlela yokululama eyinhloko ezosiza ekuqinisekiseni ukuphola okuhle:

• Phuza amanzi amaningi ukuze uhlanze umzimba wakho futhi uvimbele amahlule egazi
• Gwema ukuphakamisa izinto ezisindayo, ukuzikhandla, noma ukuzivivinya ngamandla amasonto angu-4-6
• Thatha imithi ebhalwe ngudokotela yokudambisa ubuhlungu kanye nama-antibiotics ngendlela eqondile njengoba uqondiswe
• Gwema ukushayela imoto kuze kususwe i-catheter yakho futhi uzizwe ukhululekile
• Gwema ukuzihlanganisa ngokocansi amasonto angu-4-6 ukuze uvumele ukuphola okuphelele
• Ungathathi imithi eqeda igazi ngaphandle uma ivunywe ngqo ngudokotela wakho

Kujwayelekile ngokuphelele ukubona igazi elithile emchameni wakho izinsuku eziningana noma amasonto ngisho nangemva kwe-TURP, futhi lokhu kuvame ukwehla kancane kancane. Kodwa-ke, kufanele uxhumane nodokotela wakho ngokushesha uma uhlangabezana nokuphuma kwegazi okukhulu, ukungakwazi ukuchama, ubuhlungu obukhulu, noma izimpawu zokutheleleka njengomkhuhlane noma ama-chills.

Ziyini izici eziyingozi zezinkinga ze-TURP?

Ngenkathi i-TURP ivikelekile ngokujwayelekile, izici ezithile zingakhuphula ingozi yakho yezinkinga ngesikhathi noma ngemuva kwenqubo. Ukuqonda lezi zici eziyingozi kusiza ithimba lakho lezokwelapha ukuthi lithathe izinyathelo ezifanele futhi likusize wenze isinqumo esinolwazi mayelana nokwelashwa kwakho.

Izici ezihlobene nobudala zidlala indima ebalulekile emiphumeleni ye-TURP, njengoba amadoda amadala angase abe nezimo zezempilo ezengeziwe ezithinta ukuphola nokululama. Amadoda angaphezu kweminyaka engama-80 ubudala angase abhekane nezingozi eziphakeme kancane, nakuba iziguli eziningi ezindala zisathola imiphumela emihle ngokuphathwa kwezokwelapha okufanele.

Izimo eziningana zezokwelapha zingakhuphula ingozi yakho yezinkinga ze-TURP:

• Isifo senhliziyo noma ukushaya kwenhliziyo okungajwayelekile okuthinta ukubekezelelana kwe-anesthesia
• Izifo zokujiya kwegazi ezenza ingozi yokopha ngesikhathi sokuhlinzwa
• Isifo sikashukela esinganciphisa ukuphola kwamanxeba futhi sandise ingozi yokutheleleka
• Isifo sezinso esithinta indlela umzimba wakho oqhubula ngayo imithi noketshezi
• Ukuhlinzwa kwangaphambilini kwendlala yesinye okungase kwenze inqubo yamanje ibe nzima
• Amadlala esinye amakhulu kakhulu adinga izikhathi ezinde zokuhlinzwa
• Ukutheleleka ngamathumbu omchamo okudinga ukwelashwa ngaphambi kokuhlinzwa

Udkt. ohlinzayo uzohlola ngokucophelela umlando wakho wezokwelapha kanye nesimo sempilo yamanje ukuze anciphise lezi zingozi. Kwezinye izimo, ezinye izindlela zokwelapha zingase zinconywe uma izici zakho eziyingozi zenza i-TURP ingafaneleki esimweni sakho esithile.

Ziyini izinkinga ezingase zibe khona ze-TURP?

Izinkinga ze-TURP azivamile, zenzeka ngaphansi kuka-10% weziguli, kodwa kubalulekile ukuqonda ukuthi yini engenzeka ukuze ukwazi ukubona izimpawu futhi ufune ukunakekelwa okufanele uma kudingeka. Izinkinga eziningi zisesikhashana futhi zixazululwa ngokwelashwa okufanele.

Izinkinga ezivame kakhulu ngokuvamile zithambile futhi zesikhashana, zithinta umsebenzi wakho womchamo noma wocansi amasonto ambalwa kuya ezinyangeni ngemva kokuhlinzwa. Lezi zinkinga zivame ukuzithuthukisa zodwa njengoba umzimba wakho uphola futhi uzivumelanisa nezinguquko.

Nazi izinkinga ezingaba khona okufanele uzazi, ezisohlwini kusukela kokuvamile kakhulu kuya kokungavamile kakhulu:

• Ukuphuma kwesidoda emuva (isidoda siya emgodini womchamo esikhundleni sokuphuma), okuthinta amadoda angama-65-75%
• Ukungakwazi ukuzibamba ngamanye amathuba noma ubunzima bokulawula ukugeleza komchamo
• Izifo zomgudu womchamo ezingase zidinge ukwelashwa ngama-antibiotic
• Ukungasebenzi kahle kwesitho sokuzala okwesikhashana okuvame ukuthuthuka ezinyangeni ezimbalwa
• Igazi emchameni elihlala isikhathi eside kunokulindelekile
• Ukuqina kwe-urethral (ukuncipha) okungase kudingeke ukwelashwa okwengeziwe
• Isidingo sokuhlinzwa okuphindwayo uma izicubu ze-prostate zikhula ngokuhamba kwesikhathi

Izinkinga ezingathi sína kodwa ezingavamile zihlanganisa i-TURP syndrome, eyenzeka lapho uketshezi olunisela lungena emjondolo wakho wegazi futhi luthinte ibhalansi yama-electrolyte omzimba wakho. Izindlela zokuhlinza zesimanje nokuqapha kwenze le nkinga ingavamile kakhulu, yenzeka ngaphansi kuka-1% wezinqubo.

Ngezinye izikhathi, amanye amadoda angase abe nokungakwazi ukuzibamba unomphela noma ukungasebenzi kahle ngokuphelele kwesitho sokuzala, kodwa lezi zinkinga ezinzima zenzeka ezingaphansi kuka-1-2% wamacala. Udokotela ohlinzayo uzoxoxa ngephrofayili yakho yengozi ngokuya ngesimo sakho sempilo esithile kanye nezici ze-prostate.

Kufanele ngibone nini udokotela ngemva kwe-TURP?

Kufanele uthinte udokotela wakho ngokushesha uma uhlangabezana nezimpawu ezithile zokuxwayisa ezingabonisa izinkinga ezingathi sína ezidinga ukunakekelwa kwezokwelapha okusheshayo. Ngenkathi ukululama kwe-TURP okuningi kuqhubeka kahle, ukwazi ukuthi ungasiza nini kuqinisekisa ukuthi noma yiziphi izinkinga zixazululwa ngokushesha.

Izimo eziphuthumayo ezidinga ukunakekelwa kwezokwelapha ngokushesha zihlanganisa ukungakwazi ngokuphelele ukuchama, ukuphuma kwegazi okukhulu okungami, ubuhlungu obukhulu obungalawulwa ngemithi enikeziwe, noma izimpawu zokutheleleka okukhulu. Lezi zimpawu, nakuba zingavamile, zidinga ukuhlolwa nokwelashwa ngokushesha.

Xhumana nomhlinzeki wakho wezempilo ngokushesha uma uhlangabezana nanoma yiziphi zalezi zimpawu ezikhathazayo:

• Ukungakwazi ukuchama ngaphandle kokukhipha ikhetha
• Ukuphuma kwegazi eliningi ngamaqhubu amakhulu egazi aqhubekayo
• Umkhuhlane ongaphezu kuka-101°F (38.3°C) nokubanda noma ukuthuthumela
• Ubuhlungu obukhulu besisu noma besinqulu obuqhubeka buqina ngokuhamba kwesikhathi
• Isicanucanu, ukuhlanza, noma ukudideka okwenzeka kungazelelwe
• Umuzwa ovuthayo ngesikhathi sokuchama oqhubeka uqina
• Ukuvuvukala emilenzeni yakho, esiswini, noma endaweni yakho yokuhlinzwa

Ukunakekelwa okuvamile kokulandela, ngokuvamile uzobona udokotela wakho wezifo zokuchama ngaphakathi kwamasonto angu-1-2 ngemva kokuhlinzwa, bese futhi emva kwamasonto angu-6-8 ukuze uhlole ukuqhubeka kwakho kokuphola nokuthuthuka kwezimpawu. Lawa ma-aphoyintimenti abalulekile ekuqapheni ukululama kwakho nasekuxazululeni noma yiziphi izinkathazo ongase ube nazo.

Imibuzo evame ukubuzwa mayelana ne-TURP

Q.1 Ingabe i-TURP iyasebenza ekwelapheni i-prostate enwetshiwe?

Yebo, i-TURP iyasebenza kakhulu ekwelapheni izimpawu ze-prostate enwetshiwe, ngamazinga empumelelo angama-85-90% ekuthuthukiseni ukugeleza komchamo nokunciphisa izimpawu ezicasulayo. Amadoda amaningi athola ukuthuthuka okukhulu ekwazi kwawo ukuchama, ukunciphisa ukuchama ebusuku, nokuphuma kangcono kwesinye ngaphakathi kwamasonto ngemva kwale nqubo.

Ukuthuthuka okuvela ku-TURP kuvame ukuhlala iminyaka eminingi, nakuba amanye amadoda angase adinge ukwelashwa okwengeziwe uma i-prostate yawo iqhubeka nokukhula ngokuhamba kwesikhathi. Ucwaningo lubonisa ukuthi cishe ama-80-85% amadoda ahlala enelisekile ngemiphumela yawo ye-TURP ngisho neminyaka engu-10 ngemva kokuhlinzwa.

Q.2 Ingabe i-TURP ibangela ukungasebenzi kahle kwesitho sobulili esingapheli?

I-TURP ayivamile ukubangela ukungasebenzi kahle kwesitho sobulili esingapheli, ngocwaningo olubonisa ukuthi lokhu kwenzeka kumadoda angama-5-10% kuphela. Amadoda amaningi athola izinkinga zesikhashana zokungasebenzi kahle kwesitho sobulili ngemva kwe-TURP abona ukuthuthuka ngaphakathi kwezinyanga ezingu-3-6 njengoba ukuvuvukala kwehla futhi ukugeleza kwegazi okuvamile kubuyela endaweni.

Uma ubuwasebenzisa kahle amalunga akho ngaphambi kwe-TURP, kungenzeka ukuthi uzoqhubeka nokukwenza ngemva kwalokho. Nokho, ukuchitheka kwamanzi emzimbeni (i-orgasm eyomile) kuvamile kakhulu, kuthinta cishe ama-65-75% amadoda unomphela, nakuba lokhu kungathinti injabulo yocansi noma ukuqina kwe-orgasm.

Umbuzo 3. Kuthatha isikhathi esingakanani ukululama ngemva kwe-TURP?

Ukwelashwa kwe-TURP ngokuvamile kuthatha amasonto angu-4-6 ukuze kuphole ngokuphelele, nakuba kungenzeka ukuthi uzoqaphela ukuthuthuka kwendlela yokuchama ezinsukwini zokuqala ngemva kokususwa kwe-catheter. Amadoda amaningi angabuyela emisebenzini elula nasemsebenzini wasehhovisi phakathi nesonto elilodwa, kodwa kufanele agweme ukuphakamisa izinto ezisindayo noma ukuzivocavoca okunzima ngesikhathi sokululama esiphelele samasonto angu-6.

I-catheter yakho ngokuvamile izosuswa ngemva kwezinsuku ezingu-1-3 ngemva kokuhlinzwa, futhi kufanele ubone ukuthuthuka okuqhubekayo ezimpawini zakho zokuchama emasontweni alandelayo. Ukululama okuphelele, okuhlanganisa nokuxazululwa kwanoma yimaphi imiphumela emibi yesikhashana, kungathatha izinyanga ezi-3 kwezinye izimo.

Umbuzo 4. Ingabe ukukhula kwendlala yesinye kungabuyela emuva ngemva kwe-TURP?

Izicubu zendlala yesinye zingakhula ngemva kwe-TURP njengoba ingxenye engaphandle yendlala yesinye ihlala ingathintekile, kodwa lokhu ngokuvamile kwenzeka kancane kancane eminyakeni eminingi. Cishe ama-10-15% amadoda angase adinge ukwelashwa okwengeziwe phakathi kweminyaka engu-10-15, nakuba lokhu kuhluka ngokuya ngobudala, impilo yonke, nokuthi zingakanani izicubu eziqale zasuswa.

Uma izimpawu zibuyela, ngokuvamile zithuthuka kancane kancane futhi ngokuvamile zingalawulwa ekuqaleni ngemithi. I-TURP ephindwayo noma ezinye izinqubo ezingezinye zingase zenziwe uma kunesidingo, nakuba isidingo sokuhlinzwa okwengeziwe singavamile eminyakeni eyishumi yokuqala ngemva kokwelashwa kokuqala.

Umbuzo 5. Ingabe i-TURP ingcono kunemithi yokukhulisa indlala yesinye?

I-TURP ngokuvamile isebenza kangcono kunemithi yezimpawu zokukhula kwendlala yesinye eziphakathi nendawo kuya kwezinkulu, inikeza ukuthuthuka okusheshayo nokumangalisayo ekuhambeni komchamo nasekukhululweni kwezimpawu. Nakuba imithi ingasiza izimpawu ezilula kuya kweziphakathi nendawo, ngokuvamile iba ngaphansi kokusebenza ngokuhamba kwesikhathi njengoba indlala yesinye iqhubeka nokukhula.

Noma kunjalo, ukukhetha phakathi kwe-TURP nemithi kuncike ezimpawini zakho ezithile, impilo yonke, izintandokazi zokuphila, nokuzimisela ukwamukela imiphumela engemihle engaba khona. Udokotela wakho wezifo zokuzala uzokusiza ukuthi ulinganise izinzuzo nezingozi zenketho ngayinye ngokusekelwe esimweni sakho ngasinye kanye nemigomo yokwelapha.