Ake sixoxe ngokuhlinzwa kwe-Pelvic Exenteration, okungenye yezindlela ezinkulu zokuhlinzwa komdlavuza, ngamagama alula.

Siyazi ukuthi kunzima kangakanani ukulwa nomdlavuza. Amagama awakwazi ukuchaza ubuhlungu obuzwayo lapho umdlavuza ubuya ngemva kwakho konke ukwelashwa nokuhlinzwa. Esimweni esinjalo, udokotela wakho angase akhulume nawe ngokuhlinzwa okukhulu okubizwa ngokuthi "i-Pelvic Exenteration." Kuvamile ukuzizwa wesaba futhi ushaqekile uma uzwa leli gama. Kodwa ungakhathazeki. Namuhla, sizokhuluma ngokucacile nangokulula ngokuthi lokhu kusho ukuthini ngempela, ukuthi kwenziwani, nokuthi yini ozobhekana nayo ngemva kwakho.

Kalula nje, kuyini ukukhishwa kwe-pelvic?

Ukukhipha isisu esiswini kuyindlela enkulu kakhulu futhi eyinkimbinkimbi yokwelapha umdlavuza ngaphakathi kwesisu sakho. Ngokuvamile kwenziwa njengesinyathelo sokugcina lapho zonke ezinye izindlela zokwelapha (ezifana nokwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe) zehlulekile ukulawula umdlavuza noma lapho umdlavuza usubuyile.

Lokhu kuhlinzwa kuhilela kakhulu ukususa izitho zokuzala lapho umdlavuza usakazeke khona. Ngokuvamile, lokhu kuhlinzwa kwenziwa kwabesifazane. Kodwa-ke, kwezinye izimo, amadoda nawo kufanele enze lokhu kuhlinzwa.

Lokhu kuhilela ukususa izitho ezifana nesitho sakho sangasese sowesifazane, isibeletho, kanye nomlomo wesibeletho. Kuye ngokuthi umdlavuza ususakazeke kangakanani, izingxenye zomgudu wakho womchamo kanye nomgudu wokugaya ukudla, njengesinye sakho kanye namathumbu, nazo zingadinga ukususwa.

Yiziphi izinhlobo eziyinhloko zalokhu kuhlinzwa?

Ukuhlinzwa kokukhipha isisu kwabesifazane kungahlukaniswa ngezinhlobo ezintathu eziyinhloko: Ngaphambili, Ngemuva, kanye Nokuphelele. Udokotela wakho uzonquma uhlobo lokuhlinzwa olukulungele kangcono ngokusekelwe endaweni kanye nobukhulu bomdlavuza wakho.

Kungakhathaliseki ukuthi uhlinzwa kanjani, izitho zakho zokuzala zizosuswa. Ungathola umbono ocacile ngalokhu kuthebula elingezansi.

Kuthiwani uma lokhu kuhlinzwa kwenziwa kwabesilisa?

Uma indoda ihlinzwa lokhu ngenxa yomdlavuza we-pelvic ophindaphindayo (njengomdlavuza we-urethra), odokotela abahlinzayo basusa isinyi, i-rectum, i-anus, kanye nengxenye ye-colon. Ngaphezu kwalokho, izingxenye zesimiso sokuzala, njenge-prostate gland kanye ne-seminal vesicles, nazo zingasuswa.

Kungani kunconywa ukuhlinzwa okukhulu kangaka?

Ngenxa yokuthi lokhu kuyindlela enkulu kakhulu yokuhlinzwa, odokotela batusa kuphela uma kungekho enye indlela. Izizathu eziyinhloko yilezi:

• Uma ezinye izindlela zokwelapha (imisebe, i-chemotherapy) zingakwazi ukwelapha umdlavuza.
• Ngisho noma isimila somdlavuza sisuswa ngokuhlinzwa, umdlavuza ungabuyela endaweni efanayo noma usakazekele ezithweni eziseduze.

Lokhu kuhlinzwa kuvame ukwenziwa kumdlavuza wezifo zabesifazane. Isibonelo:

• Umdlavuza wesitho sangasese sowesifazane
• Umdlavuza wesibeletho
• Umdlavuza wesibeletho
• Umdlavuza we-vulvar

Kwenzekani ngaphambi kokuhlinzwa?

Ngaphambi kokuhlinzwa okukhulu okufana nalokhu, uzohlolwa kahle. Udokotela wakho cishe uzoyala ukuhlolwa okufana ne-MRI scan noma i-CT scan ukuze athole izithombe ezicacile zezitho zakho zesisu. Lezi zithombe zizobasiza ukuhlela ukuhlinzwa.

Ngaphezu kwalokho, ikutshela nokuthi wenze izinto ezifana nalezi:

• Eminye imithi, ikakhulukazi imithi yokunciphisa igazi, kungadingeka iyekwe ezinsukwini ezimbalwa ngaphambi kokuhlinzwa.
• Bakutshela ukuthi ungadli noma uphuze lutho ngobusuku obandulela ukuhlinzwa.
• Udokotela wakho uzokunikeza imiyalelo ecacile ngakho konke lokhu.

Kwenzekani ngesikhathi sokuhlinzwa?

Ngaphambi kokuba ukuhlinzwa kuqale, uzonikezwa umuthi obulala izinzwa ojwayelekile (umuthi ofakwa engalweni yakho ngemithambo). Lokhu kusho ukuthi uzolala phakathi nokuhlinzwa, ngakho ngeke uzwe ubuhlungu.

Imininingwane yokuhlinzwa izohluka kuye ngohlobo lokuhlinzwa olwenzile. Udokotela ohlinzayo uzokwenza izimbobo eziningana esiswini sakho futhi asuse ngokucophelela izitho zokuzala ezinomdlavuza, futhi uma kudingeka, nezinye izitho. Ngezinye izikhathi, inqubo engabangeli zinkinga ingafakwa kakhulu.

Indlela entsha yokukhipha umchamo nendle

Lona umehluko omkhulu kakhulu kulokhu kuhlinzwa.

• Uma isinye sakho sisusiwe: Kuzodingeka udale indlela entsha yokuthi umchamo uphume emzimbeni wakho. Ngezinye izikhathi kuthathwa ingxenye yamathumbu akho bese isetshenziselwa ukudala into efana nesinye esisha. Noma, amapayipi aphuma ezinso zakho axhunywe embotsheni encane esikhumbeni sesisu sakho. Lokhu kubizwa ngokuthi i-urostomy . Umchamo uqoqwa esikhwameni esixhunywe kulembobo.
• Uma ingxenye yamathumbu kanye ne-anus (i-Colon/Rectum/Anus) isusiwe: Indlela entsha yokuphuma kwendle idalwa ngendlela efanayo. Ingxenye esele yamathumbu ixhunywe embobeni eyenziwe esikhumbeni sesisu. Lokhu kubizwa ngokuthi i-colostomy . Isikhwama esixhunywe kulokhu siqoqa indle.

Lokhu kuhlinzwa konke ngokuvamile kungathatha cishe amahora ayi-12 .

Kwenzekani ngemva kokuhlinzwa?

Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela isikhathi eside. Abanye abantu kufanele bahlale esibhedlela amasonto amaningana. Phakathi nalesi sikhathi, odokotela nabahlengikazi bazoqapha impilo yakho ngokucophelela futhi bakunike imithi yokulawula ubuhlungu.

Abanye besifazane bakhetha ukuvuselelwa kwesitho sangasese sowesifazane ( vaginoplasty ) ngemva kwalokhu kuhlinzwa. Uma unesifiso salokhu, ungakhuluma nodokotela wakho ngakho.

Ngemva kokubuyela ekhaya, isibhedlela sizokunikeza imiyalelo eningiliziwe yokuthi ungayinakekela kanjani imivimbo yakho yokuhlinzwa nokuthi ungayigcina kanjani ihlanzekile uma une-colostomy noma i-urostomy. Kubaluleke kakhulu ukulandela imiyalelo ngokucophelela ukuze ugweme noma yiziphi izinkinga.

Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?

Kodwa-ke, njengazo zonke izinhlobo zokuhlinzwa okukhulu, kunezingozi ezithile. Lokhu kufaka phakathi:

• Ukuvaleka kwamathumbu , okusho ukuthi ukudla akuhambi kahle.
• Ukutheleleka.
• Izinkinga ngezimbobo ezintsha (ama-ostomies) ezidalwe ukuvumela umchamo nendle ukuthi kuphume.
• Ukusabalala kokutheleleka egazini ( i-Sepsis ).
• Ukopha okukhulu noma ukuqhekeka kwegazi .
• Amanxeba okuhlinzwa ayavuvukala, abe bomvu, noma aphinde avulwe.
• I-fistula yesitho sangasese sowesifazane iyimbobo ephakathi kwesitho sangasese sowesifazane nezinye izitho zangaphakathi (isib., isinyi).
• Nakuba kungavamile kakhulu, kunengozi yokufa ngemva kwalokhu kuhlinzwa. Udokotela wakho uzoxoxa nawe ngalokhu ngokukhululekile.

Kuthatha isikhathi esingakanani ukuphulukiswa?

Lena yingxenye enzima kakhulu. Isikhathi sokululama side futhi siyinselele.

• Kuzodingeka uphumule ngokuphelele amasonto ambalwa ngemva kokuhlinzwa. Akukhuthazwa ukwenza noma yimuphi umsebenzi womzimba.
• Kuze kube yilapho uzizwa ungcono kancane, uzodinga usizo oluvela elungwini lomndeni ngezinto ezifana nokugeza, ukugqoka, nokuhamba.
• Kuye ngohlobo lokuhlinzwa olwenzile, ungase ungakwazi ukuhlala cishe amasonto ayisishiyagalombili. Ungase ukwazi ukuma nokugoba, kodwa kuzoba nzima ukuma isikhathi eside.
• Abanye abantu bakuthola kunzima ukuhlala uqonde izinyanga, ngisho neminyaka, ngemva kokuhlinzwa. Lokhu kungenxa yokuthi inani elikhulu lezitho nezicubu ezazisekela ukwakheka kwesisu sakho kanye ne-pelvis zisusiwe.
• Buza udokotela wakho mayelana nokuzivocavoca kanye nokwelashwa ngokomzimba ongakwenza ukuze uqinise imisipha yesisu kanye neyasemhlane.
• Kubaluleke kakhulu futhi ukuhlala uqinile engqondweni phakathi nalesi sikhathi. Ukwelulekwa nokukhuluma namaqembu okusekelana nabantu abake badlula kulolu hlinzwa njengani kuzoba umthombo omkhulu wamandla.

Kukuziphi izimo lapho udinga ukubonana nodokotela ngokushesha?

Ngemva kokuhlinzwa, kuzodingeka ubone udokotela wakho njalo ukuze ahlolwe. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezingezansi, shayela udokotela wakho ngokushesha.

• Ukopha noma ukuvuvukala okukhulu okuvela endaweni yesisu.
• Umkhuhlane, ukubomvu kanye nokuvuvukala okuzungeze inxeba lokuhlinzwa (lezi yizimpawu zokutheleleka).
• Ubuhlungu besisu obungabekezeleleki.
• Ubunzima noma ukungakwazi ukulawula ukuchama noma ukuphuma kwendle.
• Isicanucanu nokuhlanza.
• Ukuqunjelwa.

Ukukhipha isisu esiswini kuyindlela yokuhlinzwa eshintsha impilo. Kodwa kungaba yindlela esindisa impilo futhi esindisa impilo. Ngaphambi kokwenza lesi sinqumo, kubalulekile ukuxoxa ngazo zonke izinkinga zakho nodokotela wakho bese uthola ukuqonda okucacile nokungokoqobo.