Ingabe uvame ukuzizwa sengathi unendawo elumayo, enamaqhubu eduze kwendunu yakho? Abantu abaningi banamahloni okukhuluma ngalezi zinto, futhi lokho kuyinto evamile. Kodwa ukuqaphela lezi zimpawu nokungazinaki kubaluleke kakhulu empilweni yakho. Namuhla sizokhuluma ngesimo abantu abaningi abangakaze bezwe ngaso, kodwa kubalulekile ukwazi ngaso. Leso yi-Anal Dysplasia.
Kalula nje, iyini i-Anal Dysplasia?
Ungesabi uma uzwa igama elithi Anal Dysplasia. Akuyona umdlavuza. Kodwa, kafushane nje, ushintsho olungavamile emaseli endunu yakho. Lolu shintsho lungandisa ingozi yakho yokuthola umdlavuza wendunu esikhathini esizayo. Ngakho-ke, lungabizwa ngokuthi "isandulela" noma "isibonakaliso sesixwayiso" somdlavuza.
Cabanga ngakho njengokungathi kukhona umfantu omncane odongeni. Lowo mfantu akusho ukuthi udonga luwile. Kodwa kuwuphawu lokuthi udinga ukulunaka futhi uthathe izinyathelo ezidingekayo. I-Anal Dysplasia ingenye yezinto ezinjalo.
Abacwaningi bezokwelapha bakholelwa ukuthi imbangela eyinhloko yalesi simo yi-Human Papillomavirus, noma ezinye izinhlobo zegciwane le-HPV esizaziyo sonke. Abantu abane-HIV nabo basengozini enkulu yokuthola lesi simo. Into engcono kakhulu ukuthi ukuthola umuthi wokugomela i-HPV nokuzivikela ekuthelelekeni nge-HPV kunganciphisa kakhulu ingozi yokuthola i-Anal Dysplasia.
Lesi simo sithinta kanjani umzimba?
I-Anal Dysplasia iqala olwelwesini olumanzi lwendunu yakho. Siyibiza ngokuthi i-mucosa. Kulesi simo, amangqamuzana aphilile kulolu lwelwesi aphenduka kancane kancane abe amangqamuzana angajwayelekile. Lawa maseli angajwayelekile avame ukukhula lapho indunu ihlangana khona ne-rectum. Kodwa ngezinye izikhathi angakhula nasesikhumbeni ngaphandle kwendunu (isikhumba se-perianal).
Esikhathini esiningi, lesi simo asibangeli zimpawu ezithile, kodwa abanye abantu bangase babhekane nezinto ezifana nalezi:
- Ukuluma okungabekezeleleki okungapheli okuzungeze indunu.
- Uma uyithinta ngomunwe wakho, kuzwakala sengathi ubambe into efana neqhubu elincane noma isimila.
- Abanye abantu bahlushwa yizinhlungu ezungeze indunu. Lezi zinhlungu azinawo umdlavuza, kodwa ziwuphawu lokutheleleka nge-HPV.
Odokotela babiza lesi simo ngokuthi i-Anal Intraepithelial Neoplasia (AIN) noma i-Squamous Intraepithelial Lesions (SILs). Sihlukaniswe kakhulu ngezigaba ezimbili. Sinqunywa ngokuhlola amaseli ngaphansi kwe-microscope.
| Izinga lekhwalithi (Ibanga) | Incazelo elula |
|---|---|
| I-SIL yezinga eliphansi (i-LSIL) (Izinga eliphansi lengozi) | Kulesi sigaba, amangqamuzana angajwayelekile afana kakhulu namangqamuzana anempilo. Lesi simo sivame ukuzixazulula ngokwaso ngaphandle kokwelashwa. Ingozi yokuba nomdlavuza iphansi kakhulu. |
| I-SIL yezinga eliphezulu (i-HSIL) (Izinga eliphezulu lengozi) | Kulesi sigaba, amaseli abonakala engajwayelekile. Lesi simo cishe ngeke sithuthuke ngaphandle kokwelashwa. Ngokuhamba kwesikhathi, uma singelashwa, kukhona ingozi yokuba nomdlavuza we-rectal. |
Into ebalulekile ukuthi izinga eliphansi (i-LSIL) aliguquki libe umdlavuza. Kodwa-ke, izinga eliphezulu (i-HSIL) yinto okufanele ikhathazeke ngayo.
Ucwaningo lwamuva nje luthole ukuthi phakathi kuka-3% no-14% wabantu abanomdlavuza wendunu wezinga eliphezulu (HSIL) bazoqala ukuba nawo. Kodwa-ke, le ngozi iyahlukahluka kuye ngomuntu nomuntu. Isibonelo, abantu abane-HIV abane-dysplasia yendunu basengozini enkulu yokuba nomdlavuza.
Yiziphi izici eziyingozi zokuthuthukisa i-Anal Dysplasia?
Kunezici eziningana ezandisa amathuba okuba lesi simo senzeke. Lezi yizi:
- Ukutheleleka ngezinhlobo ezithile zegciwane le-HPV: Lena imbangela eyinhloko.
- Ukuya ocansini lwendunu: Ngisho noma kusetshenziswa amakhondomu, kunengozi yokuthi igciwane le-HPV lingadluliselwa ezindaweni zesikhumba ezingamboziwe yikhondomu.
- Ukutheleleka ngegciwane lesandulela ngculazi: Igciwane lesandulela ngculazi lenza buthaka amasosha omzimba, linciphise amandla alo okulwa nokutheleleka nge-HPV.
- Ukubhema: Amakhemikhali akugwayi alimaza amangqamuzana omzimba futhi andise ingozi yomdlavuza.
- Isimiso somzimba sokuzivikela esibuthakathaka: Abantu abanesimiso somzimba sokuzivikela esibuthakathaka ngenxa yemithi ethile (isib. imithi enikezwa ngemva kokufakelwa izitho zomzimba) noma ezinye izimo zokuzivikela komzimba nabo basengozini enkulu.
Udokotela usithola kanjani lesi simo?
Uma unalezi zimpawu, udokotela wakho angase afune ukwenza izivivinyo ezithile ukuqinisekisa ukuthi unalesi simo. Ungabi namahloni noma wesabe ngalokhu. Lezi izivivinyo zezokwelapha ezivamile.
| Indlela yokuhlola | Kalula nje, wenzani ngalokhu? |
|---|---|
| Ukuhlolwa Kwedijithali Kwe-Rectal | Udokotela uzosebenzisa umunwe ogqokile ukuze ahlole i-rectum yakho futhi ahlole ukuthi akukho yini amaqhubu noma amaqhubu. |
| I-Anal Pap Smear | Kufana nokuhlolwa kwe-Pap, okusetshenziselwa ukuhlola umdlavuza wesibeletho. Kufakwa i-swab e-rectum ukuze kuthathwe isampula yamaseli, bese ehlolwa ngaphansi kwe-microscope ukuze kubonakale ukuthi akhona yini amaseli angajwayelekile. |
| I-Anoscopy | Ithuluzi elincane elifana nethubhu (i-anoscope) lifakwa endunu ukuze kubhekwe ngqo ezicutshini ezingaphakathi ukuze kutholakale ukukhubazeka. Ngezinye izikhathi uketshezi olukhethekile lusetshenziswa ukwenza izindawo ezinamaseli angajwayelekile zibonakale kahle (i-High-Resolution Anoscopy). |
| Ukuhlolwa kwebhayoloji | Uma kukhona ukusolakala kwamangqamuzana angajwayelekile, kuthathwa ingcezu encane yezicubu kuleyo ndawo bese ithunyelwa elabhorethri ukuze ihlolwe. Lena yindlela kuphela yokuqinisekisa ukuthi i-100% iyi-Anal Dysplasia noma umdlavuza. |
| I-CT Scan | Kuphela uma ukuhlolwa kuqinisekisa umdlavuza, lokhu kuhlolwa kwenziwa ukuze kubonakale ukuthi ngabe ususakazekele kwezinye izingxenye zomzimba. |
Yiziphi izindlela zokwelapha lokhu?
Indlela yokwelapha incike ekutheni unezinga elingakanani le-dysplasia (elisezingeni eliphansi noma eliphezulu).
- Izinga eliphansi (LSIL): Ezimweni eziningi, udokotela ngeke aselaphe lesi simo futhi uzosibona isikhashana, njengoba lokhu kuvame ukuzixazulula ngokwako.
- I-High-grade (HSIL): Lesi yisimo esingaholela kumdlavuza esikhathini esizayo, ngakho-ke ukwelashwa kuyadingeka ukuze kususwe amangqamuzana angavamile. Kunezindlela eziningana zokwenza lokhu.
Udokotela wakho uzokhetha ukwelashwa okukufanele kakhulu futhi okunemiphumela emibi embalwa kakhulu. Uzokuchazela kahle. Akukho okufanele ukwesabe. Ezinye zezinketho zokwelapha yilezi:
- Ukwelashwa nge-Laser: Ukusebenzisa imisebe ye-laser ukubhubhisa izicubu ezinamaseli angajwayelekile.
- I-Electrocautery (EC): Ukususwa kwamaseli angajwayelekile kusetshenziswa idivayisi kagesi.
- I-TCA (i-Trichloroacetic acid): Uhlobo olukhethekile lwe-asidi lucwiliswa ebholeni likakotini bese lufakwa ezindaweni lapho kukhona khona amangqamuzana angavamile, luwabhubhise.
- Ukuhlinzwa: Kwezinye izimo, indawo enezicubu ezingavamile isuswa ngokuhlinzwa.
Yini esingayenza ukuze sinciphise ingozi?
Indlela engcono kakhulu nephumelela kakhulu yokuvimbela lesi simo ukuzivikela egciwaneni le-HPV elisibangelayo. Kunezinto eziningana ongayenza ukuze wenze lokhu:
- Ukuthola umuthi wokugomela i-HPV: Lena yindlela engcono kakhulu yokuvimbela ukutheleleka kwe-HPV. Ukuthola umuthi wokugomela kungavikela futhi ekuphazamisekeni kwe-anal dysplasia kanye neminye imidlavuza ehlobene ne-HPV, njengomdlavuza wesibeletho.
- Imikhuba yocansi ephephile: Ukusebenzisa ikhondomu ngendlela efanele njalo uma uya ocansini kunganciphisa ingozi yokuthola izifo ezithathelwana ngocansi, okuhlanganisa ne-HPV.
- Ukunciphisa inani labalingani bocansi: Ingozi yokutheleleka nge-HPV iyanda ngenani labalingani.
- Gwema ukubhema: Uma ubhema, ukuyeka ukubhema kubaluleke kakhulu empilweni yakho iyonke kanye nokunciphisa le ngozi.
- Ukuhlolwa njalo kwezokwelapha: Uma uwela kwelinye lamaqembu asengozini okukhulunywe ngawo ngenhla (isib., uma une-HIV), khuluma nodokotela wakho mayelana nokuhlolwa lesi simo.
Uzobona nini udokotela
Uma unezimpawu ezinjengalezi, ungabi namahloni futhi ubone udokotela ngokushesha.
- Ukulunywa okuqhubekayo endunu.
- Uma uzwa iqhubu noma isimila kuleyo ndawo.
- Uma uzwa ubuhlungu endulwini.
- Uma kukhona ukopha ngendle noma ngezinye izikhathi.
Umlayezo Wokuya Nawe Ekhaya
- I-anal dysplasia akuyona umdlavuza.Kodwa kuyisixwayiso sokuthi umdlavuza ungase ukhule esikhathini esizayo.
- Imbangela enkulu yalokhu igciwane le-HPV. Ngakho-ke, kubaluleke kakhulu ukuthola umuthi wokugomela i-HPV nokwenza imikhuba yocansi ephephile.
- Uma unezimpawu ezifana nokulunywa, amaqhubu, noma ubuhlungu e-rectum yakho , ungabi namahloni noma ulibale ukubona udokotela. Uma kusheshe kwatholakala, kuba lula kakhulu ukukwelapha.
- I-Low-grade (LSIL) ivame ukuba ngcono ngokwayo. I-High-grade (HSIL) inezindlela zokwelapha eziphumelelayo.
- Ukukhuluma ngokukhululekile ngezinkinga zezempilo ezinjengalezi kanye nokuqaphela kuyindlela engcono kakhulu yokuhlala uphilile.
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