Ua noi ʻia hoʻi ʻoe e hana i kahi MRI Prostate Biopsy? (MRI-Guided Prostate Biopsy) E aʻo kākou e pili ana i kēia me ka maʻalahi!

Ua kānalua anei kāu kauka i kahi pilikia me kou kelepa prostate a ua haʻi aku iā ʻoe e pono ʻoe e hana i kahi biopsy (kahi ʻāpana liʻiliʻi o ka ʻiʻo i lawe ʻia a nānā ʻia me ka hoʻohana ʻana i kahi scan MRI) e ʻike pono ai? He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe i kahi mea e like me kēia. Akā ke ʻike pono ʻoe i ke ʻano o kēia hoʻāʻo, pehea e hana ʻia ai, a pehea e hoʻomākaukau ai no ia mea, e nalo aku kou makaʻu. E kamaʻilio maʻalahi kākou e pili ana i kēia.

ʻO ka mea mua, e nānā kākou, he aha kēia biopsy prostate i alakaʻi ʻia e MRI?

I ka ʻōlelo maʻalahi, he hoʻāʻo kūikawā kēia no ka ʻike ʻana i ke kanesa prostate, inā pēlā, e ʻike i ke kahua o ia mea, a e hoʻolālā i ka mālama ʻana. Pili kēia i ka lawe ʻana i nā laʻana ʻiʻo liʻiliʻi loa mai kou prostate me ka hoʻohana ʻana i ka ʻenehana MRI a me ultrasound, e hāʻawi ana i nā kiʻi maopopo loa . A laila e nānā kahi pathologist i kēia mau laʻana ʻiʻo ma lalo o kahi microscope e hoʻoholo ai inā loaʻa iā lākou nā hunaola kanesa.

He aha ke kelepa prostate?

ʻO kou prostate kekahi ʻāpana o kāu ʻōnaehana hānau kāne a me ka ʻōnaehana mimi. He ʻāpana ia e like me ka nui o ka walnut aia ma ke alo o kou ʻōpū mimi. Hana ia i ka wai seminal, ʻo ia ka wai e hui pū me ka sperm i kou ejaculate. Kōkua kēia wai i ka mālama ʻana i ke olakino o ka sperm a kōkua iā ʻoe e hāpai.

Holo kou urethra ma o ke kelepa prostate. Ke mimi ʻoe, puka mai ka mimi mai ka ʻōpū mimi ma o ka penis, a ke puka ʻoe, puka mai ka sperm ma o kēia ʻōmole.

He aha nā ʻano hana e hana ai i kēia biopsy?

ʻElua mau ʻano nui no ka loaʻa ʻana o nā hāpana ʻiʻo mai ka prostate. E wehewehe kāu kauka iā ʻoe i ke ʻano hana kūpono loa no kou kūlana.

E aʻo kākou e pili ana i kekahi mau ʻenehana holomua hou aʻe.

I kēia mau lā, hoʻohana ʻia nā ʻenehana holomua e hoʻopololei i kēia ʻano hana.

• MRI Multiparametric (mpMRI): He ʻano MRI ʻoi aku ka naʻauao a me ka holomua ma mua o ka MRI maʻamau. Hiki iā ia ke ʻike maopopo i nā loli kanesa i loko o ka ʻōpū prostate ma mua o ka MRI maʻamau. Eia nō naʻe, ʻaʻole hiki i ka mpMRI wale nō ke 100% maopopo ʻaʻohe kanesa. No laila, pono pinepine ka biopsy.
• ʻO ka biopsy prostate i alakaʻi ʻia e ka Fusion: He ʻano hana hoihoi loa kēia. Pili ia i ka "hoʻohui" ʻana i nā kiʻi MRI a me nā kiʻi ultrasound (TRUS - Transrectal Ultrasound) e hana i hoʻokahi kiʻi. Loaʻa mua iā ʻoe kahi MRI. A laila, i ka wā o ka biopsy, hoʻohana ke kauka i nā polokalamu kūikawā e hoʻohui i nā kiʻi MRI a me nā kiʻi ultrasound i lawe ʻia i ka manawa like. ʻAe kēia i ke kauka e kuhikuhi pololei i nā wahi kānalua o ka prostate a lawe i nā laʻana ʻiʻo.

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No ke aha he mea pono e hana i ia ʻano hoʻokolohua?

Hiki i nā kauka ke hōʻoia i kekahi mau mea ma o kēia hoʻokolohua.

• E ʻike pono inā he maʻi ʻaʻai prostate kou a ʻaʻole paha.
• Inā he maʻi kanesa, e hoʻoholo i kona ʻano/ikaika .
• E nānā e ʻike inā ua hoʻi hou mai ke kanesa ma hope o ka mālama ʻia ʻana ma mua.
• I kekahi manawa, hiki ke ʻike ʻia a kāpae ʻia nā kūlana ʻē aʻe e like me nā hōʻailona o ke kanesa akā ʻaʻole ia he kanesa (e.g., nā kelepa nui, nā maʻi) he kanesa.

ʻAʻole pono ka hopena o ka hoʻāʻo koko PSA kiʻekiʻe e hōʻike i ka maʻi kanesa. Hiki nō hoʻi ke kumu o ka hoʻonui ʻia ʻana o ka prostate (BPH - Benign Prostatic Hyperplasia) a i ʻole kahi maʻi (Prostatitis). Hiki i kēia hoʻāʻo ke kōkua i ka hoʻokaʻawale ʻana ma waena o kēia mau kūlana.

ʻO wai ka mea maʻamau e pono ai kēia hoʻokolohua?

Aia kekahi mau kūlana e kuhikuhi paha ai kāu kauka iā ʻoe no kēia hoʻokolohua.

• Inā ʻoi aku ka kiʻekiʻe o ka PSA (Prostate-Specific Antigen) i loko o kou koko ma mua o ka maʻamau.
• Inā ʻike ke kauka i kahi puʻupuʻu a i ʻole kahi paʻakikī loa i loko o ka ʻōpū prostate i ka wā o ka hoʻokolokolo rectal digital (DRE).
• Inā ua hōʻike kahi scan MRI ma mua i kekahi mea kānalua .
• Inā hoʻomau ka piʻi ʻana o kāu pae PSA ʻoiai ʻaʻole i loaʻa ka maʻi kanesa i kahi biopsy i hana ʻia me ka ultrasound maʻamau.
• Inā ua ʻike mua ʻia ʻoe me ke kanesa prostate a ke nānā ʻia nei ʻoe me ka ʻole o ka lāʻau lapaʻau.

Pehea ʻoe e hoʻomākaukau ai ma mua o ka hoʻokolohua?

He mea nui loa kēia. Pono ʻoe e hahai pololei i nā kuhikuhi a ke kauka. ʻO ka maʻamau, ʻo ia ka mea a lākou e haʻi aku ai iā ʻoe e hana.

He aha ka mea e hana ʻia i ka wā o ka hoʻāʻo?

Pono mua ʻoe e hana i kahi scan MRI. Hiki ke hāʻawi ʻia iā ʻoe kahi wai kūikawā (contrast dye) ma o kahi aa koko ma kou lima e kiʻi i nā kiʻi ʻoi aku ka maopopo.

Hana pinepine ʻia ka biopsy ma ke ʻano outpatient. ʻO ia hoʻi, hiki iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi. Hoʻokomo ʻia kahi anesthetic kūloko i loko o ka ʻāpana a puni ka prostate gland. E kōkua kēia iā ʻoe e hōʻemi i ka ʻeha. Hiki ke hāʻawi ʻia iā ʻoe kahi sedative akahai e kōkua iā ʻoe e hoʻomaha. No laila, he manaʻo maikaʻi ke loaʻa i kekahi e hoʻokele iā ʻoe i ka home inā hewa kekahi mea.

ʻO ka maʻamau, lawe ke kauka ma kahi o 12 a 16 mau laʻana ʻiʻo mai nā ʻāpana like ʻole o ka prostate. Hiki iā ʻoe ke manaʻo i kahi kaomi iki i kēia manawa, akā ʻaʻole ʻoe e manaʻo i kekahi ʻeha nui.

He aha ka mea e manaʻo ai ma hope o ka hoʻāʻo?

Hiki iā ʻoe ke hoʻi i ka home i kekahi mau hola ma hope o ka hoʻāʻo. He mea maʻamau kēia mau mea no nā lā e hiki mai ana.

• Aia paha he kahe koko a me ka ʻeha iki ma kahi i hana ʻia ai ka biopsy.
• Loaʻa paha iā ʻoe kahi koko liʻiliʻi i loko o kou mimi (hematuria) a i ʻole ka semen (hematospermia) no kekahi mau lā. He mea maʻamau kēia, mai hopohopo.
• Pono ʻoe e lawe i nā antibiotics i kuhikuhi ʻia e ke kauka e like me ke kauoha .

ʻEhia ka lōʻihi e ʻike ai i nā hopena?

E hoʻouna ʻia ka hāpana ʻiʻo i lawe ʻia mai ou aku i kahi keʻena hoʻokolohua. ʻO ka maʻamau, ma kahi o hoʻokahi pule , i kekahi manawa ʻoi aku ka lōʻihi, e loaʻa ai nā hopena.

Hiki ke loaʻa ʻekolu mau ʻano nui o nā hopena:

• Maikaʻi ʻole: ʻAʻohe mau hunaola kanesa i loaʻa. Eia nō naʻe, he mea kākaʻikahi loa, hiki ke loaʻa nā hopena wahaheʻe maikaʻi ʻole, kahi e hala ai ka hoʻāʻo ʻana i ka maʻi kanesa ʻoiai aia ia. Inā kiʻekiʻe mau kou pae PSA, e noi paha kāu kauka iā ʻoe e hoʻāʻo hou ʻia i loko o kekahi mau mahina.
• Maikaʻi: Ua loaʻa nā hunaola kanesa. ʻO ia hoʻi, aia ke kanesa prostate. E kamaʻilio ke kauka me ʻoe e pili ana i nā hana aʻe, nā koho lapaʻau, a i ʻole ka nānā ʻana.
• Kānalua: He ʻano ʻē nā hopena, akā ʻaʻole maopopo inā loaʻa ka maʻi kanesa a ʻaʻole paha. I kēia manawa, hiki ke ʻōlelo ʻia e hoʻāʻo hou ʻia a i ʻole ka biopsy hou ʻana i loko o kekahi mau mahina.

Pehea e ana ʻia ai ke koʻikoʻi o ka maʻi kanesa?

Inā loaʻa nā hunaola kanesa i ka hoʻāʻo ʻana, e hāʻawi ke kauka maʻi i nā hunaola i kahi māka mai ka 1 a i ka 5 ma muli o ko lākou ʻano. A laila, hoʻohui ʻia nā māka ʻelua maʻamau e hāʻawi i kahi waiwai i kapa ʻia ʻo ka helu Gleason (hiki ke piʻi kēia mai ka 6 a i ka 10). ʻOi aku ka nui o ka laha ʻana o nā kanesa me ka helu Gleason kiʻekiʻe (e.g., 8, 9, 10) ma mua o nā kanesa me ka helu haʻahaʻa (e.g., 6). Hiki i kēia helu ke kōkua i kāu kauka e koho i ka lāʻau lapaʻau maikaʻi loa nāu.

I ka wā e pono ai ʻoe e ʻike i ke kauka

Inā loaʻa iā ʻoe nā hōʻailona o ka maʻi, e like me ke kuni a me ke anu , ma hope o ka biopsy, pono ʻoe e kāhea koke i kāu kauka.

Eia kekahi, inā hoʻomau a ʻoi aku paha ka ʻino o nā hōʻailona ma lalo nei, e ʻimi pono i ke kōkua lapaʻau.

• Ke kū ʻana o ke koko i loko o ka mimi a i ʻole ka sperm.
• Ka hana ʻino o ka erectile.
• ʻO ka pono pinepine e mimi i ka pō (nocturia).
• ʻEha i ka wā mimi a i ʻole ka ejaculation.
• Ka paʻakikī i ka kāohi ʻana i ka mimi, nāwaliwali a i ʻole ke kahe ʻana o ka mimi i hoʻopau ʻia.