He maha ngā wā ka rongo koe he mākūkū, he puku te wāhi e karapoti ana i tō nono? He maha ngā tāngata e whakama ana ki te kōrero mō ēnei mea, ā, he mea noa tēnā. Engari he mea nui te mōhio ki ēnei tohu, me te kore e aro ki a rātou mō tō hauora. I tēnei rā ka kōrero tātou mō tētahi āhuatanga kāore anō kia rongohia e te tini tāngata, engari he mea nui kia mōhiotia. Ko te Anal Dysplasia tēnā.
He aha te Anal Dysplasia?
Kaua e mataku ina rongo koe i te kupu Anal Dysplasia. Ehara i te mate pukupuku. Engari, he rerekētanga rerekē tēnei i roto i ngā pūtau o tō nono. Ka taea e tēnei huringa te whakanui ake i tō tupono ki te whakawhanake i te mate pukupuku nono ā muri ake nei. Nō reira, ka taea te kī he "tohu whakatūpato" rānei mō te mate pukupuku.
Whakaarohia he rite ki te pakaru iti i te pakitara. Ehara i te mea kua hinga te pakitara i taua pakaru. Engari he tohu tēnei me aro atu koe ki tēnā, me mahi hoki i ngā mahi e tika ana. Ko te Anal Dysplasia tētahi o aua mea.
E whakapono ana ngā kairangahau hauora ko te tino take o tēnei mate ko te Human Papillomavirus, arā, ētahi momo huaketo HPV e mōhiotia ana e tātou katoa. He nui ake hoki te tūponotanga o te hunga whai HIV ki te whakawhanake i tēnei mate. Ko te mea pai rawa atu, mā te whiwhi i te kano ārai mate HPV me te tiaki i a koe anō i te mate HPV ka taea te whakaiti i te tūponotanga o te whakawhanake i te Anal Dysplasia.
He aha te pānga o tēnei āhuatanga ki te tinana?
Ka tīmata te Anal Dysplasia i roto i te arai makuku o tō nono. Ka kiia e mātou ko te mucosa. I roto i tēnei āhuatanga, ka huri haere ngā pūtau hauora o tēnei arai hei pūtau rerekē. He maha ngā wā ka puta ēnei pūtau rerekē ki te wāhi e tūtaki ai te nono ki te rectum. Engari i ētahi wā ka taea hoki te puta i roto i te kiri i waho o te nono (kiri perianal).
I te nuinga o te wā, kāore he tohu motuhake e puta mai i tēnei mate, engari ka pāngia pea ētahi tāngata e ēnei āhuatanga:
- He mākūkū pumau, kāore e taea te manawanui huri noa i te nono.
- Ina pā atu koe ki tō matihao, e rite ana koe ki te mea kei te pupuri koe i tētahi mea pērā i tētahi puku iti, i tētahi pukupuku rānei.
- Ka puta he kiritona ki ētahi tāngata huri noa i te nono. Ehara ēnei kiritona i te mate pukupuku, engari he tohu noa iho nō te mate HPV.
E kiia ana tēnei mate e ngā tākuta ko te Anal Intraepithelial Neoplasia (AIN) ko te Squamous Intraepithelial Lesions (SILs) rānei. E rua ngā wāhanga matua. Ka kitea mā te tirotiro i ngā pūtau i raro i te karuārai.
| Taumata kounga (Kaupae) | He whakamārama māmā |
|---|---|
| SIL iti-kōeke (LSIL) (Taumata mōrearea iti) | I tēnei wā, he tino rite ngā pūtau rerekē ki ngā pūtau hauora. He maha ngā wā ka memeha noa iho tēnei āhuatanga, kāore he maimoatanga. He tino iti te tūponotanga kia huri hei matepukupuku. |
| SIL kounga teitei (HSIL) (Taumata mōrearea teitei ake) | I tēnei wā, he āhua rerekē te āhua o ngā pūtau. Kāore pea tēnei āhua e pai ake mēnā kāore he maimoatanga. I roto i te wā, ki te kore e rongoatia, ka tūpono te whakawhanake i te mate pukupuku o te kōpū. |
Ko te mea nui, kia kaua te matepukupuku iti (LSIL) e huri hei matepukupuku. Heoi, he mea hei āwangawanga mā te matepukupuku teitei (HSIL).
I kitea i roto i tētahi rangahau tata nei, kei waenganui i te 3% me te 14% o te hunga whai mate pukupuku anal teitei (HSIL) ka pāngia e te mate pukupuku anal. Heoi, he rerekē tēnei mōrearea i ia tangata, i ia tangata. Hei tauira, ko te hunga whai HIV me te anal dysplasia he nui ake te mōrearea ki te pāngia e te mate pukupuku.
He aha ngā āhuatanga mōrearea e pā ana ki te whakawhanaketanga o te Anal Dysplasia?
He maha ngā āhuatanga e whakanui ake ana i te tūponotanga o tēnei mate. Ko ēnei:
- Te mate i ētahi momo huaketo HPV: Koinei te tino take.
- Te moe tāne me te wahine: Ahakoa e whakamahia ana he ure tāne, tera pea ka horapa te huaketo HPV mā roto i ngā wāhi kiri kāore i hipokina e te ure tāne.
- Te pangia e te huaketo HIV: Ka ngoikore te pūnaha ārai mate o te tinana e te HIV, ka whakaiti i tōna kaha ki te whawhai ki te mate HPV.
- Te kai hikareti: Ka kino ngā matū i roto i ngā hikareti i ngā pūtau o te tinana, ā, ka piki ake te mōrearea o te mate pukupuku.
- Pūnaha ārai mate ngoikore: Ko te hunga he ngoikore ō rātou pūnaha ārai mate nā ētahi rongoā (hei tauira, ngā rongoā i hoatu i muri i te whakawhitinga okana) me ētahi atu mate ārai mate rānei, ka nui ake te mōrearea ki tēnei mate.
Me pēhea te tātaritanga a te tākuta i tēnei mate?
Mena kei a koe ēnei tohu, ka hiahia pea tō tākuta ki te whakahaere i ētahi whakamātautau hei whakaū mēnā kei a koe tēnei mate. Kaua e whakama, kaua hoki e mataku mō tēnei. He whakamātautau hauora noa ēnei.
| Tikanga whakamātautau | Hei whakarāpopototanga, he aha tāu e mahi ai ki tēnei? |
|---|---|
| Whakamātautau Rekereke Mamati | Ka whakamahia e te tākuta he matihao karapu hei tirotiro i tō pūkahukahu, hei rapu hoki i ngā puku, i ngā puku rānei. |
| Pap Smear mō te ihu | He rite ki te whakamātautau Pap, e whakamahia ana hei tirotiro mō te mate pukupuku o te kaki. Ka whakaurua he swab ki roto i te rectum hei tango i tētahi tauira o ngā pūtau, kātahi ka tirohia i raro i te karuārai hei tirotiro mēnā he pūtau rerekē kei roto. |
| Anoskopia | Ka whakauruhia he taputapu iti rite ki te ngongo (anoscope) ki roto i te nono hei tirotiro tika i ngā kiko o roto mō ngā āhuatanga rerekē. I ētahi wā ka whakamahia he wai motuhake hei whakamārama i ngā wāhi kei reira ngā pūtau rerekē (High-Resolution Anoscopy). |
| Te koiora | Mena he whakapae kei te puta he pūtau rerekē, ka tangohia he wahi kiko iti mai i taua wāhi ka tukuna ki te taiwhanga hei whakamātautau. Koinei anake te huarahi hei whakaū 100% mēnā he Anal Dysplasia, he mate pukupuku rānei. |
| Matawai CT | Mēnā ka whakaūtia e ngā whakamātautau te mate pukupuku, ka mahia tēnei whakamātautau hei tirotiro mēnā kua horapa ki ētahi atu wāhanga o te tinana. |
He aha ngā maimoatanga mō tēnei?
Ko te tikanga maimoatanga e whakawhirinaki ana ki te taumata o te dysplasia kei a koe (iti, teitei rānei).
- Teitei-iti (LSIL): I te nuinga o te wā, kāore te tākuta e rongoā i te mate, ka tirotiro noa i te mate mō tētahi wā, nā te mea ka ea noa iho ēnei i a rātou anō.
- Teitei-kounga (HSIL): Tērā pea ka huri hei matepukupuku ā muri ake nei, nō reira me rongoā hei tango i ngā pūtau rerekē. He maha ngā huarahi hei mahi i tēnei.
Mā tō tākuta e whiriwhiri te maimoatanga e tino tika ana māu, ā, he iti rawa ngā pānga taha. Māna e whakamārama atu ki a koe. Kāore he mea hei wehi. Ko ētahi o ngā kōwhiringa maimoatanga ko:
- Maimoatanga Reera: Te whakamahi i ngā hihi reera hei whakangaro i ngā kiko kei roto ngā pūtau rerekē.
- Te tango hiko (Electrocautery - EC): Te tango i ngā pūtau rerekē mā te whakamahi i tētahi taputapu hiko.
- TCA (Waikawa Trichloroacetic): Ka rumakina he momo waikawa motuhake ki roto i te pōro miro, ka pania ki ngā wāhi kei reira ngā pūtau rerekē, ka whakangaromia.
- Pokanga: I ētahi wā, ka tangohia te wāhi he kiko rerekē.
He aha tā tātou e taea ai te whakaiti i te mōrearea?
Ko te huarahi pai rawa atu, me te huarahi tino whai hua hei ārai i tēnei mate ko te tiaki i a koe anō i te huaketo HPV e hua ai tēnei mate. He maha ngā mea ka taea e koe te mahi hei mahi i tēnei:
- Te whiwhi i te kano ārai HPV: Koinei te huarahi pai hei ārai i te mate HPV. Ka taea hoki e te whiwhi i te kano ārai te tiaki i te mate pukupuku anal me ētahi atu mate pukupuku e pā ana ki te HPV, pērā i te mate pukupuku waha kōpū.
- Ngā mahi moepuku haumaru: Mā te whakamahi tika i te ure i ia moepuku ka whakaiti i te tūponotanga o te pangia e ngā mate tuku iho, tae atu ki te HPV.
- Te whakawhāiti i te maha o ngā hoa moepuku: Ka piki ake te mōrearea o te mate HPV i te maha o ngā hoa.
- Āta karohia te kai hikareti: Ki te kai hikareti koe, he mea tino nui te whakamutu i te kai hikareti mō tō hauora whānui, me te whakaiti hoki i tēnei mōrearea.
- Ngā tirotiro hauora auau: Mena kei roto koe i tētahi o ngā rōpū mōrearea kua whakahuatia ake nei (hei tauira, mena he HIV-pai koe), kōrero ki tō tākuta mō te tirotiro i a koe mō tēnei mate.
Āhea te wā e kite ai i te tākuta
Ki te pā mai ēnei tohu ki a koe, kaua e whakamā, me toro atu ki te tākuta i runga i te wā tonu.
- Te mākūkū tonu i roto i te anus.
- Mena ka rongo koe i tētahi puku, i tētahi pukupuku rānei i taua wāhi.
- Mena kei te mamae tō hope.
- Mena kei te toto te tūtae, i ētahi atu wā rānei.
Karere Tangohia ki te Kāinga
- Ehara te anal dysplasia i te mate pukupuku.Engari he whakatūpato tēnei kei te whanake pea te mate pukupuku ā muri ake nei.
- Ko te huaketo HPV te tino take o tēnei. Nō reira, he mea tino nui te whiwhi i te kano ārai mate HPV me te mahi i ngā mahi moepuku haumaru.
- Ki te pā mai ngā tohu pēnei i te mākūkū, te pupuhi, te mamae rānei i roto i tō kōpū , kaua e whakamā, kaua hoki e whakaroa ki te toro atu ki te tākuta. Ko te wawe o te tātaritanga, ko te māmā ake o te rongoā.
- Ko te iti o te kounga (LSIL) ka pai ake i a ia anō. Ko te teitei o te kounga (HSIL) ka angitu ngā maimoatanga.
- Ko te kōrero tuwhera mō ngā take hauora pēnei, me te mōhio ki ēnei āhuatanga, koinei te huarahi pai ki te noho hauora.
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