Me kōrero tātou mō te Pelvic Exenteration, tētahi o ngā pokanga nui rawa atu mō te mate pukupuku, i roto i ngā kupu māmā noa iho.

E mōhio ana mātou ki te uaua o te whawhai ki te mate pukupuku. Kāore e taea te whakaahua i te mamae e pā ana ki a koe ina hoki mai te mate pukupuku i muri i ngā maimoatanga me ngā pokanga katoa. I roto i tēnei āhuatanga, tera pea kei te kōrero tō tākuta ki a koe mō tētahi pokanga nui e kiia nei ko te "Pelvic Exenteration." He mea noa te mataku me te ohorere ina rongo koe i tēnei ingoa. Engari kaua e manukanuka. I tēnei rā, ka kōrero mārama, ka kōrero māmā hoki tātou mō te tikanga o tēnei, te take e mahia ai, me ngā mea ka pā ki a koe i muri mai.

He aha te tikanga o te Pelvic Exenteration?

He pokanga nui, uaua hoki te tango i te pelvic exenteration hei rongoā i te mate pukupuku i roto i tō pelvis. Ko te tikanga ka mahia hei huarahi whakamutunga ina kore e taea e ngā maimoatanga katoa (pēnei i te chemotherapy me te radiation therapy) te whakahaere i te mate pukupuku, ina hoki mai anō rānei te mate pukupuku.

Ko te nuinga o tēnei pokanga he tango i ngā whekau whakaputa uri kua horapa te mate pukupuku. I te nuinga o te wā, ka mahia tēnei pokanga ki ngā wāhine. Heoi, i ētahi wā, me mahi anō hoki tēnei pokanga ki ngā tāne.

Ko te tango i ngā whekau pēnei i tō tara, tō kōpū, me tō kaki. I runga i te whānui o te horapa o te mate pukupuku, me tango pea ētahi wāhanga o tō ara mimi me tō ara nakunaku, pēnei i tō pūkahukahu me tō puku.

He aha ngā momo matua o tēnei pokanga?

E toru ngā momo pokanga tango i te pelvic exenteration mō ngā wāhine: Anterior, Posterior, me Total. Mā tō tākuta e whakatau te momo pokanga e pai ana mōu i runga i te wāhi me te whānuitanga o tō matepukupuku.

Ahakoa te momo pokanga ka mahia ki a koe, ka tangohia ō whekau whakaputa uri. Ka taea e koe te mārama ki tēnei mea mai i te ripanga i raro nei.

A, mehemea ka mahia tēnei pokanga ki ngā tāne?

Mena ka pokangahia tētahi tāne mō te mate pukupuku pelvic e hokihoki mai ana (pērā i te mate pukupuku urethral), ka tangohia e ngā taote pokanga te pūkahukahu, te rectum, te nono, me tētahi wāhanga o te koroni. Hei tāpiri, ka tangohia pea ētahi wāhanga o te pūnaha whakaputa uri, pērā i te repe prostate me ngā vesicles seminal.

He aha i tūtohutia ai tētahi pokanga nui pēnei?

Nā te mea he pokanga nui rawa tēnei, ka tūtohu noa ngā tākuta kia whakamahia hei rongoā whakamutunga. Ko ngā take matua ko:

• Ina kore e taea e ētahi atu maimoatanga (te irahiko, te chemotherapy) te whakaora i te mate pukupuku.
• Ahakoa ka tangohia he puku matepukupuku mā te pokanga, ka hoki anō pea te matepukupuku ki taua wāhi anō, ka horapa rānei ki ngā whekau tata.

He maha ngā wā ka mahia tēnei pokanga mō ngā mate pukupuku wahine. Hei tauira:

• Matepukupuku tara
• Matepukupuku kōpū
• Matepukupuku o te kōpū
• Matepukupuku vulvar

He aha ngā mea ka tupu i mua i te pokanga?

I mua i tētahi pokanga nui pēnei, ka tirotirohia koe. Tērā pea ka whakahau tō tākuta i tētahi whakamātautau pēnei i te MRI scan , i te CT scan rānei kia mārama ai ngā whakaahua o ō whekau hope. Mā ēnei whakaahua rātou e āwhina ki te whakamahere i te pokanga.

Hei tāpiri, e kī ana hoki ki a koe kia mahi i ngā mea penei:

• Me mutu te tango i ētahi rongoā, inā koa ngā rongoā whakaiti toto, i ētahi rā i mua i te pokanga.
• Ka kī atu rātou kia kaua e kai, e inu rānei i tetahi mea i te pō i mua i te pokanga.
• Mā tō tākuta koe e hoatu he tohutohu mārama mō ēnei mea katoa.

He aha ngā mea ka tupu i te wā o te pokanga?

I mua i te tīmatanga o te pokanga, ka tukuna he rongoā whakamoe whānui ki a koe (he rongoā e tukuna ana mā roto i te uaua ki roto i tō ringa). Ko te tikanga ka moe koe i te roanga o te pokanga, nō reira kāore koe e rongo i te mamae.

Ka rerekē ngā taipitopito o te pokanga i runga i te momo pokanga e mahia ana e koe. Ka tapahia e te taote pokanga ētahi tapahi i roto i tō puku, ā, ka tangohia marietia ngā whekau whakaputa uri matepukupuku, me ētahi atu whekau mēnā e tika ana. I ētahi wā, ka taea te mahi i tētahi tikanga iti rawa te whakaekenga.

He huarahi hou hei tuku i te mimi me te paru

Koinei te rerekētanga nui rawa atu o tēnei pokanga.

• Mena ka tangohia tō pūkahukahu: Me waihanga e koe he ara hou mō te mimi kia puta i tō tinana. I ētahi wā ka tangohia he wāhanga o tō ake whekau ka whakamahia hei hanga i tētahi mea pērā i te pūkahukahu hou. Mēnā rānei, ka honoa ngā ngongo e ahu mai ana i ō whatukuhu ki tētahi kōhao iti i te kiri o tō puku. Ka kiia tēnei he urostomy . Ka kohia te mimi ki roto i tētahi putea e hono ana ki tēnei kōhao.
• Ki te tangohia tetahi wāhanga o te whekau me te nono (Coron/Rectum/Anus): Ka hangaia he ara hou mō te putanga o te paru i te ara kotahi. Ka honoa te toenga o te whekau ki tētahi kōhao i hangaia i roto i te kiri o te puku. Ka kiia tēnei he colostomy . Ka kohia te paru e tētahi putea e hono ana ki tēnei.

E 12 hāora pea te roa o tēnei pokanga katoa.

He aha ngā mea ka tupu i muri i te pokanga?

I muri i te pokanga, me noho roa koe ki te hōhipera. Ko ētahi tāngata me noho ki te hōhipera mō ētahi wiki. I tēnei wā, ka tirotirohia tō hauora e ngā tākuta me ngā nēhi, ā, ka hoatu he rongoā hei whakahaere i te mamae.

Ka whiriwhiri ētahi wāhine kia whakahoutia te tara ( vaginoplasty ) i muri i tēnei pokanga. Mēnā kei te hiahia koe ki tēnei, ka taea e koe te kōrero ki tō tākuta mō tēnei mea.

Kia hoki koe ki te kāinga, ka hoatu e te hōhipera he tohutohu taipitopito mō te tiaki i ō tapahi pokanga, me te pupuri i te ma o aua tapahi mēnā he colostomy, he urostomy rānei tōu. He mea tino nui kia ata whai i ngā tohutohu kia kore ai e puta he raruraru.

He aha ngā painga me ngā mōrearea o tēnei pokanga?

Heoi, pērā i ngā pokanga nui katoa, kei reira ētahi mōrearea. Ko ētahi o ēnei ko:

• Te aukati i te puku , arā, kāore te kai e neke tika ana.
• Te mate urutā.
• Ngā raruraru ki ngā pūaha hou (ostomies) e hangaia ana hei tuku i te mimi me te paru ki waho.
• Te horapa o te mate ki te toto ( Sepsis ).
• Te toto toto nui, te toto totoka rānei.
• Ka pupuhi, ka whero, ka tuwhera anō rānei ngā patunga pokanga.
• He kōhao te fistula tara i waenganui i te tara me ētahi atu whekau o roto (hei tauira, te pūkahukahu).
• Ahakoa he tino onge, tera pea ka mate i muri i tēnei pokanga. Ka kōrero tuwhera atu tō tākuta ki a koe mō tēnei.

Kia pēhea te roa o te wā e ora ai?

Koinei te wāhanga tino uaua. He roa, he uaua hoki te wā whakaora.

• Me okioki rawa koe mō ētahi wiki i muri i te pokanga. Kāore i te tūtohutia kia uru atu koe ki tētahi mahi whakakori tinana.
• Kia pai ake rā anō tō āhua, me tino hiahia koe ki te āwhina a tētahi mema o te whānau mō ngā mea pēnei i te kaukau, te whakakakahu, me te hikoi.
• I runga i te momo pokanga i mahia ki a koe, tērā pea kāore e taea e koe te noho mō te 8 wiki pea. Tērā pea ka taea e koe te tū me te piko, engari ka uaua te tū mō te wā roa.
• He uaua ki ētahi tāngata te noho tika mō ngā marama, tae noa ki ngā tau, i muri i te pokanga. Nā te mea kua tangohia te nuinga o ngā okana me ngā kiko i tautoko i tō puku me tō hope.
• Pātai atu ki tō tākuta mō ngā mahi whakakori tinana me te whakaora tinana ka taea e koe te mahi hei whakapakari i ō uaua puku me tō tuara.
• He mea tino nui hoki kia kaha tonu te hinengaro i tēnei wā. He puna nui te kaha mā te tuku tohutohu me te kōrero ki ngā rōpū tautoko e pā ana ki te hunga kua pāngia e tēnei pokanga pērā i a koe.

I roto i ēhea āhuatanga me toro atu koe ki te tākuta tonu?

I muri i te pokanga, me toro atu koe ki tō tākuta i ia wā, i ia wā, mō ngā tirotiro hauora. Heoi, ki te pāngia koe e tētahi o ngā tohu i raro nei, waea atu ki tō tākuta tonu.

• Te toto, te pupuhi nui rānei mai i te puku.
• Te kirika, te whero me te pupuhi huri noa i te patunga pokanga (he tohu ēnei o te mate pāwera).
• Te mamae o te puku e kore e taea te whakamanawanui.
• Te uaua, te kore rānei e taea te whakahaere i te mimi, i te tutae rānei.
• Whakapairuaki me te ruaki.
• Te mate kōroke.

He pokanga whakarerekē ora te tango i te pelvic exenteration. Engari he kōwhiringa whakaora ora, he kōwhiringa whakaora ora hoki. I mua i te whakatau i tēnei, he mea nui kia kōrerohia ō āwangawanga katoa ki tō tākuta, kia mārama ai, kia pono ai hoki.