Kya bulijjo okuwulira ng’otya katono n’okweraliikirira ng’olaba ekigambo ‘SIL’ oba ‘Squamous Intraepithelial Lesion’ ku lipoota oluvannyuma lw’okukeberebwa Pap. Ebintu nga "Kino kye ki? Nnina kookolo?" kiyinza okujja amangu ddala mu birowoozo. Naye tosattira. Fuuwa omukka omungi era okkakkane. SIL si kookolo. Naye kintu kye twetaaga okukimanya. Kale, leero tugenda kwogera mu ngeri ennyangu ennyo ku SIL kye ki, lwaki ekulaakulana, ne kiki eky’okugikolako.
Mu ngeri ennyangu, SIL eno kye ki?
SIL oba Squamous Intraepithelial Lesion , mbeera obutoffaali obuli kungulu ku lususu lw’omubiri gwaffe naddala obutoffaali obuli mu bitundu ebigonvu ebibikka ebitundu ebimu, gye bukula mu ngeri ey’enjawulo katono, etali ya bulijjo okusinga eya bulijjo. Ekigambo "intraepithelial" kyennyini kitegeeza nti enkyukakyuka eno eri mu layeri ey'okungulu yokka ey'olususu/olususu, era tegenda mu buziba.
Lowooza ku lususu lwaffe ng’ekisenge ky’amabaati ekitegekeddwa obulungi. Mu SIL, kiringa olunyiriri lw’amabaati olw’okungulu mu bbugwe ono ow’amabaati olusimbuddwa ne lulina enkula ey’enjawulo. Bbugwe akyali mugumu, naye waliwo enjawulo entono mu layeri ey’okungulu.
Enkyukakyuka z’obutoffaali ez’ekika kino zisobola okubaawo mu bitundu by’omubiri gwaffe bingi eby’enjawulo. Ebisinga okumanyibwa bye bino:
- Omumwa gwa nnabaana
- Obukyala
- Ekitundu ky’obukyala eky’ebweru (Vulva) .
- Anus
- Obusajja
- Emabega w’emimiro gyo
Ekikulu nti SIL si kookolo . Naye tugiyita precancer . Ekyo kitegeeza nti singa tetujjanjaba n’okufaayo ku nkyukakyuka z’obutoffaali zino okumala ebbanga ddene, waliwo omukisa nti zijja kufuuka kookolo mu biseera eby’omu maaso. Eno y’ensonga lwaki kikulu nnyo okukizuula nga bukyali.
Waliwo ebika bya SIL bibiri ebikulu:
Abasawo batunuulira obutoffaali buno obukyusiddwa nga bakozesa microscope ne bagabanya SIL mu bika bibiri ebikulu, okusinziira ku ngeri obutoffaali gye bwawukana ku butoffaali obwa bulijjo.
| Ekika kya SIL | Ennyinyonnyola ennyangu |
|---|---|
| SIL ey’omutindo ogwa wansi (LSIL) . (Obulwadde bw’okuzimba omubiri obutono) . | Eno nkyukakyuka ntono mu butoffaali. Kiringa omuddo ogumera mu lusuku. Ebisinga ku bino bisobola okufugibwa abaserikale b’omubiri gwaffe. Ekyo kitegeeza nti batera okutereera ku lwabwe nga tebalina bujjanjabi bwonna. Obulabe bw’okufuuka kookolo butono nnyo. |
| SIL ey’omutindo ogwa waggulu (HSIL) . (Obulwadde bw’okusannyalala obw’ekigero/Obuzibu obw’amaanyi) . | Waliwo enkyukakyuka ey'amaanyi, entegeerekeka mu butoffaali wano. Mu kyokulabirako kye kimu okuva mu lusuku, bino biba binene katono, ng’omuddo ogusimbye emirandira ne gumera. Tebatera kutereera ku lwabwe . Kale okusobola okuziremesa okufuuka kookolo mu biseera eby’omu maaso, ebiseera ebisinga olina okukola ekika ky’obujjanjabi . |
Ensonga enkulu evuddeko SIL okukulaakulanya y’eruwa?
Ekisinga era ekisinga okuvaako SIL ye Human Papillomavirus , oba HPV , obulwadde bw’ekikaba (STI). HPV y’evunaanyizibwa ku bitundu nga 90% ku balwadde ba SIL.
Akawuka ka HPV bwe kayingira mu mubiri gwaffe, kakosa obutoffaali obumu, ekibuleetera okwawukana amangu era mu ngeri ey’enjawulo okusinga eya bulijjo. Kino kye kivaako SIL.
Naye wuuno ekintu: Waliwo ebika bya HPV ebisoba mu 100.
- Ebika ebimu (e.g. HPV 6, 11) bika bya bulabe butono. Bino bitera okuleeta ebintu ng’enkwaso mu bitundu by’ekyama n’embeera za LSIL.
- Ebika ebirala ebimu (e.g. HPV 16, 18) bitwalibwa ng’ebika bya ``akabi ennyo``. Ebika bino eby’akabi ennyo bitera okuleeta HSIL ne kookolo.
Ebiseera ebisinga, abaserikale b’omubiri gwaffe basobola okulwanyisa obulwadde bwa HPV ne bubugoba mu mubiri mu myezi mitono oba omwaka gumu oba ebiri. Naye oluusi naddala ebika eby’akabi ennyo, bisobola okusigala mu mubiri ne bireeta mpola enkyukakyuka mu butoffaali okumala emyaka mingi, ekivaako SIL.
Bubonero ki obulaga embeera eno?
Ekimu ku bisinga okusoomoozebwa wano kwe kuba nti kumpi tewali bubonero bwonna bulaga SIL . Abantu bangi bakizuula nti balina embeera eno nga bayita mu Pap smear oba gynecological exam ekoleddwa olw’ensonga endala.
Kyokka oluusi obubonero buno wammanga buyinza okulabika. Bw’oba weetegereza bino, olina okulaba omusawo wo.
Ku bikwata ku kitundu ky’ekyama:
- Okuvaamu amazzi mu bukyala oba okuvaamu omusaayi mu ngeri etaali ya bulijjo (naddala ebweru w’ensonga oba oluvannyuma lw’okwegatta) .
- Okulabika kw’ebizimba oba enkwaso mu bitundu by’ekyama
- Okwokya oba okusiiwa
- Obulumi obuluma
- Okumyuuka kw’ekitundu
Singa SIL ebaawo emabega w’emimiro:
- Okulumwa amatu
- Okuwuuma kw’eddoboozi
- Obulumi ng’omira ekintu
- Obulumi bw’emimiro obuwangaala
- Endwadde ezizimba mu bulago
Eno y’ensonga lwaki kikulu nnyo omukyala okukeberebwa Pap smear buli luvannyuma lwa kiseera , ne bw’aba talina bubonero.
Ani ali mu bulabe obw’amaanyi obw’okukwatibwa SIL?
Wadde ng’omuntu yenna alina obulwadde bwa HPV asobola okufuna SIL, abantu abamu bali mu bulabe obusingako katono.
- Abantu abalina abaserikale b’omubiri abanafu: Abantu abalina akawuka ka siriimu, abasimbulizibwa ebitundu by’omubiri oba abo abalina abaserikale b’omubiri abanafuye olw’embeera endala ez’obujjanjabi bazibuwalirwa okulwanyisa akawuka ka HPV.
- Abanywa sigala: Eddagala eriri mu sigala lyonoona obutoffaali bwaffe ne linafuya abaserikale baffe, ekizibuwalira abanywa sigala okufuga obulwadde bwa HPV.
- Enneeyisa y’okwegatta etali nnungi: Okubeera n’ababeezi abangi n’obutakozesa nkola za kwekuuma nga kondomu kyongera obulabe bw’okukwatibwa obulwadde bwa HPV.
Omusawo azuula atya obulwadde bwa SIL?
Waliwo okukeberebwa okuwerako okuzuula SIL.
1. Pap Smear: Kino kye kigezo ekisinga obukulu era ekisinga okukozesebwa. Mu kukebera kuno, akatundu akatono ak’obutoffaali kaggyibwa mu nnabaana ne kakeberebwa mu microscope okulaba oba waliwo ebitali bya bulijjo. Anal Pap smear era esobola okukozesebwa okuzuula SIL mu nseke.
2. Colposcopy: Singa lipoota yo eya Pap smear eraga nti SIL, omusawo wo ajja kulagira okukeberebwa kuno. Kino kizingiramu okukozesa ekintu eky’enjawulo ekikuza omubiri ekiyitibwa ‘colposcope’ okutunuulira omumwa gwa nnabaana n’obukyala. Bwe wabaawo ekintu kyonna ekitali kya bulijjo, kiyinza okulabibwa obulungi.
3. Okukebera ebitundu by’omubiri: Singa omusawo alaba ekitundu kyonna ekiteeberezebwa mu kiseera ky’okukebera omubiri (colposcopy), akatundu akatono ennyo kaggyibwamu ne kasindikibwa mu laabu okukeberebwa. Kino kiyitibwa biopsy. Kino kye kisalawo oba SIL, LSIL, HSIL, oba ekintu ekisingako obukulu.
‘Negative for squamous intraepithelial lesion’ kitegeeza ki?
Singa lipoota yo eya Pap smear egamba nti ``(NILM - Negative for Intraepithelial Lesion oba Malignancy)``, ago mawulire malungi nnyo. Kitegeeza nti tewali buzibu bwonna oba obubonero bwa kookolo nga tannafuna bwasangibwa mu butoffaali bwo obw’omumwa gwa nnabaana. Naye ne bwe kiba nti ekivuddemu kino kirungi, kikulu okugoberera omusawo wo mu biseera ebiragiddwa.Kikulu nnyo okugenda mu maaso n’okukeberebwa Pap smear.
Bujjanjabi ki obuweebwa SIL?
Enkola y’obujjanjabi esinziira ku oba olina LSIL oba HSIL, gy’eri, n’emyaka gyo n’obulamu bwo.
- Ku LSIL: Emisango gya LSIL egisinga naddala mu bakyala abato gigonjoolwa ku bwabwe awatali bujjanjabi bwonna. Kale omusawo wo ajja kutera okugoberera enkola ya "watchful waiting". Ekyo kitegeeza okukeberebwa Pap smear buli luvannyuma lwa myezi 6 okutuuka ku mwaka okulaba oba enkyukakyuka z’obutoffaali zeeyongera oba zitereera.
- Ku HSIL: HSIL etera okwetaaga obujjanjabi kubanga erina emikisa mingi egy’okufuuka kookolo okusinga LSIL. Waliwo obujjanjabi obuwerako:
| Enkola y’obujjanjabi | Engeri y’okukikola |
|---|---|
| Obujjanjabi obukozesebwa ku mubiri | Mu mbeera ezimu, basiiga ekizigo mu kifo obutoffaali obutali bwa bulijjo we bubeera. Bino bitta obutoffaali obutali bwa bulijjo oba okusitula abaserikale b’omubiri. |
| Obujjanjabi bwa Cryotherapy | Ekintu ekinyogovu ennyo, gamba nga nayitrojeni ow’amazzi, kikozesebwa okufuumuula n’okusaanyaawo ebitundu ebirimu obutoffaali obutali bwa bulijjo. |
| Obujjanjabi bwa layisi | Ekitangaala kya layisi eky’amaanyi kiragirwa okwokya n’okuggyawo ebitundu ebitali bya bulijjo. |
| Okulongoosa okusalako ebitundu by’omubiri | Eno y’enkola esinga okukozesebwa. LEEP (Loop Electrosurgical Excision Procedure) oba Cone Biopsy okuzuula HSIL y’omumwa gwa nnabaanaMu nkola nga eno, ekitundu kyokka ekirimu obutoffaali obutali bwa bulijjo kye kisalibwamu mu ngeri ya kkooni ne kiggyibwamu. |
Omukisa guli gutya okukwatibwa kookolo singa oba olina HSIL?
Kino kitiisa kinene eri abantu bangi. Olw’okuba lipoota egamba nti HSIL tekitegeeza nti olina kookolo. Kitegeeza kyokka nti waliwo obutoffaali obumu obuyinza okufuuka kookolo.
Okusinziira ku kunoonyereza, singa tebajjanjabwa, abalwadde ba HSIL balina emikisa mitono gya bitundu 2% gyokka okufuuka kookolo. Naye tewali ayinza kwogera bbanga ki lye kinaatwala ekyo okubaawo. Kiyinza okuba emyaka 10, kiyinza okuba emyezi 10.
Eno y’ensonga lwaki tetutwala bulabe bwonna, era amangu ddala nga tukakasiddwa nti tulina HSIL, tuggyawo obutoffaali obwo obutali bwa bulijjo n’obujjanjabi obutuufu omusawo bw’agamba. Bwe tukola bwe tutyo, kumpi tusobola okukomya ddala akabi k’okukwatibwa kookolo.
SIL esobola okuziyizibwa?
Engeri esinga obulungi era ennungi ey’okuziyiza SIL kwe kwewala okukwatibwa akawuka ka HPV, nga kano ke kasinga okubuleetera.
1. Funa eddagala eriweweeza ku bulwadde bwa HPV: Kino kye kintu ekisinga obukulu. Eddagala erigema HPV likuuma ebitundu 90% ku bika bya HPV ebikulu ebireeta kookolo ne SIL. Okugema kuno ku myaka emituufu (ebiseera ebisinga eri abawala n’abalenzi abali wakati w’emyaka 9-14) kiyinza okukendeeza ennyo ku bulabe obw’omu maaso. Bw’oba osukka emyaka egyo, buuza omusawo wo oba eddagala lino erigema lituukira ddala ku myaka gyo.
2. Okwegatta okutali kwa bulabe: Okukozesa obulungi kondomu buli lwe weegatta kiyinza okukukuuma endwadde z’ekikaba omuli ne HPV.
3. Okukomya ababeezi: Obulabe bw’okukwatibwa obulwadde bwa HPV bweyongera n’omuwendo gw’abaagalana.
4. Funa Pap smears mu budde: Ne bw’oba tolina bubonero bwonna, funa Pap smear mu biseera omusawo by’akugamba okusinziira ku myaka gyo n’akabi kwo. Singa wabaawo enkyukakyuka yonna, esobola okukwatibwa ku ddaala lya LSIL nga tennagenda mu maaso ku mbeera ya maanyi nnyo nga HSIL.
Kya bulijjo okutya ng’ozuuliddwa nti olina SIL. Naye si y'enkomerero y'ensi. Kwe kulabula kw'omubiri gwo, nga mugamba nti, "Wano waliwo akatono, ka tufaayo ku kino." Yogerako mu lwatu n’omusawo wo era owulirize amakulu ga lipoota. Beera mulambulukufu ku ky’olina okukola ekiddako. Singa ezuulibwa nga bukyali era n’ejjanjabwa obulungi, eno embeera ewonyezebwa ddala.
Obubaka Obutwala Awaka
- SIL (Squamous Intraepithelial Lesion) si kookolo. Embeera ebeerawo nga kookolo tannabaawo era eyinza okufuuka kookolo.
- Ekisinga okuvaako kino ye kawuka ka HPV akasiigibwa mu by’okwegatta.
- Waliwo ebika bibiri ebya SIL: LSIL (enkyukakyuka entono, etera okugonjoola ku bwayo ) ne HSIL (enkyukakyuka ey’omutindo ogwa waggulu, yeetaaga obujjanjabi).
- SIL etera obutaba na bubonero bwonna, n’olwekyo kikulu nnyo okukeberebwa Pap mu budde.
- Ne bwe kiba nti HSIL ebaawo, okuzuula amangu n’okujjanjaba obulungi (e.g., LEEP) kumpi kuyinza okuziyiza ddala okukula kwa kookolo.
- Okugema eddagala lya HPV n’okwegatta mu ngeri ey’obukuumi y’engeri ezisinga okuziyiza SIL.
- Bw’oba olina ekikweraliikiriza oba ky’obuusabuusa ku lipoota yo, saba omusawo akunnyonnyola.
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