Iprostatectomy egqibeleleyo

I-radical prostatectomy (ukususwa kweprostate) lutyando lokususa yonke indlala yesinye kunye nezinye izihlunu ezijikelezileyo. Kuyenziwa ukunyanga umhlaza webele.

Kukho iindidi ezi-4 eziphambili okanye ubuchule botyando olukhulu lweprostatectomy. Ezi nkqubo zithatha malunga neeyure ezi-2 ukuya kwezi-4:

• Ukubuyela umva -Ugqirha wakho wotyando uyakusika ukuqala nje ngezantsi kwesisu sakho esifikelela kwithambo lakho le-pubic. Olu tyando luthatha imizuzu engama-90 ukuya kwiiyure ezi-4.
• Laparoscopic -Ugqirha wenza utyando oluncinci endaweni yokusika okukhulu. Ixesha elide, izixhobo ezincinci zibekwe ngaphakathi kokusika. Ugqirha ubeka ityhubhu ebhityileyo enekhamera yevidiyo (laparoscope) ngaphakathi kwenye yokusika. Oku kuvumela ugqirha ukuba abone ngaphakathi kwesisu sakho ngexesha lenkqubo.
• Utyando lweerobhothi Ngamanye amaxesha, utyando lwe-laparoscopic lwenziwa kusetyenziswa inkqubo yeerobhothi. Ugqirha uhambisa izixhobo kunye nekhamera esebenzisa iingalo zerobhothi ngelixa ehleli kwikhonsoli yolawulo kufutshane netafile yokusebenza. Ayizizo zonke izibhedlele ezibonelela ngotyando lweerobhothi.
• Ngqo -Ugqirha wakho usika isikhumba phakathi kwe-anus yakho kunye nesiseko se-scrotum (i-perineum). Ukunqunyulwa kuncinci kunendlela ye-retropubic. Olu hlobo lotyando ludla ngokuthatha ixesha elincinci kwaye lubangele ukulahleka kwegazi okuncinci. Nangona kunjalo, kunzima kugqirha ukuba ayeke imithambo-luvo ejikeleze iprostate okanye asuse ii-lymph node ezikufutshane nale ndlela.

Kule nkqubo, unokuba ne-anesthesia ngokubanzi ukuze ulale kwaye ungabi nazintlungu. Okanye, uya kufumana iyeza lokunciphisa isiqingatha esisezantsi somzimba wakho (i-spinal or epidural anesthesia).

• Ugqirha ususa idlala lobudoda kwizicwili ezijikelezileyo. Iingubo zangaphantsi zesisu, ezibini iisanti ezincinci ezizaliswe lulwelo ecaleni kweprotrate yakho, nazo ziyasuswa.
• Ugqirha uya kukhathalela ukudala umonakalo omncinci kunokwenzeka kwimithambo yegazi kunye nemithambo yegazi.
• Ugqirha ubambelela kwi-urethra kwinxalenye yesinyi ebizwa ngokuba yintamo yesinyi. I-urethra yityhubhu ehambisa umchamo kwisinyi ngaphandle ngepenisi.
• Ugqirha wakho ususa i-lymph node kwi-pelvis ukujonga umhlaza.
• Umsele, obizwa ngokuba yiJackson-Pratt drain, ungasala esiswini sakho ukukhupha ulwelo olongezelelekileyo emva kotyando.
• Umbhobho (i-catheter) ushiywe kwi-urethra yakho kunye nesinyi ukukhupha umchamo. Oku kuyakuhlala endaweni yeentsuku ezimbalwa ukuya kwiiveki ezimbalwa.

I-radical prostatectomy ihlala isenziwa xa umhlaza ungakhange usasazeke ngaphaya kweprotrate gland. Oku kubizwa ngokuba ngumhlaza webele wendlala.

Ugqirha wakho unokucebisa unyango olunye ngenxa yento eyaziwayo ngohlobo lwakho lomhlaza kunye nemingcipheko yakho. Okanye, ugqirha wakho unokuthetha nawe ngezinye iindlela zonyango ezinokuba zilungile kumhlaza wakho. Olu nyango lunokusetyenziswa endaweni yoqhaqho okanye emva kokwenziwa kotyando.

Izinto ekufuneka ziqwalaselwe xa ukhetha uhlobo lotyando lubandakanya iminyaka yakho kunye nezinye iingxaki zonyango. Olu tyando luhlala lusenziwa kumadoda aphilileyo kulindeleke ukuba aphile iminyaka eli-10 okanye nangaphezulu emva kwenkqubo.

Iingozi zale nkqubo zezi:

• Iingxaki zokulawula umchamo (ukungahambi kakuhle komchamo)
• Iingxaki zokwakhiwa (ukungabi namandla)
• Ukulimala kwi-rectum
• Ukuqiniswa kwe-Urreral (ukuqiniswa kokuvulwa komchamo ngenxa yezicubu ezibomvu)

Unokutyelela amaninzi kunye nomboneleli wakho wezempilo. Uya kuba novavanyo olupheleleyo lomzimba kwaye unokuba nolunye uvavanyo. Umboneleli wakho uya kuqinisekisa ukuba iingxaki zesifo seswekile, uxinzelelo lwegazi oluphezulu, kunye neengxaki zentliziyo okanye zemiphunga zilawulwa.

Ukuba uyatshaya, kuya kufuneka uyeke iiveki ezimbalwa ngaphambi kotyando. Umboneleli wakho unokunceda.

Soloko uxelela umboneleli wakho ukuba zeziphi iziyobisi, iivithamini kunye nezinye izongezo ozithathayo, kwanezo uzithengileyo ngaphandle kommiselo.

Ngexesha leeveki ngaphambi kotyando:

• Unokucelwa ukuba uyeke ukuthatha i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), i-vitamin E, i-clopidogrel (i-Plavix), i-warfarin (i-Coumadin), kunye nawaphi na amanye amacoci egazi okanye iziyobisi ezenza kube nzima kwigazi lakho. ukugquma.
• Buza ukuba zeziphi iziyobisi ekufuneka uzithathile ngosuku lotyando lwakho.
• Ngosuku ngaphambi kotyando lwakho, sela ulwelo olucacileyo.
• Ngamanye amaxesha, unokucelwa ngumboneleli wakho ukuba athathe i-laxative ekhethekileyo ngosuku ngaphambi kokuhlinzwa kwakho. Oku kuyakucoca imixholo ikholoni yakho.

Ngomhla wotyando lwakho:

• Musa ukutya okanye usele nantoni na emva kobusuku ezinzulwini zobusuku ngaphambi kotyando lwakho.
• Thatha la mayeza uxelelwe ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Uzakuxelelwa ukuba ufike nini esibhedlele. Qiniseka ukuba ufika ngexesha.

Lungisa ikhaya lakho xa ufika ekhaya emva kotyando.

Uninzi lwabantu luhlala esibhedlele kangangeentsuku ezi-1 ukuya kwezi-4. Emva kotyando lwe-laparoscopic okanye irobotic, ungaya ekhaya kusuku olulandelayo emva kwenkqubo.

Kuya kufuneka uhlale ebhedini kude kube kusasa emva kotyando. Uya kukhuthazwa ukuba ujikeleze kangangoko emva koko.

Umongikazi wakho uya kukunceda utshintshe indawo ebhedini kwaye akubonise imithambo yokugcina igazi lihamba. Uya kufunda nokukhohlela okanye ukuphefumla nzulu ukuthintela inyumoniya. Kuya kufuneka wenze la manyathelo qho kwiiyure ezi-1 ukuya kwezi-2. Kuya kufuneka usebenzise isixhobo sokuphefumla ukugcina imiphunga yakho icacile.

Emva kotyando lwakho, unga:

• Nxiba izitokhwe ezikhethekileyo kwimilenze yakho ukunqanda amahlwili egazi.
• Fumana iyeza lentlungu kwimithambo yakho okanye uthathe iipilisi zentlungu.
• Yiva spasms kwisinyi sakho.
• Yiba necatheter kaFoley kwisinyi sakho xa ubuyela ekhaya.

Utyando kufuneka lususe zonke iiseli zomhlaza. Nangona kunjalo, uya kujongwa ngononophelo ukuqinisekisa ukuba umhlaza awubuyi. Kuya kufuneka uhlolwe rhoqo, kubandakanya uvavanyo lwegazi lwe-antigen (PSA).

Kuxhomekeke kwiziphumo zezifo kunye neziphumo zovavanyo lwe-PSA emva kokususwa kweprostate, umboneleli wakho unokuxoxa ngonyango lwemitha okanye unyango lwehomoni kunye nawe.

Prostatectomy - ngokugqibeleleyo; I-radial retropubic prostatectomy; I-radical perineal prostatectomy; I-laparoscopic radical prostatectomy; LRP; Irobotate encediswa yirobhothi; RALP; I-Pelvic lymphadenectomy; Umhlaza wedlala lobudoda - Prostatectomy; Ukususwa kweprostate - ngokugqibeleleyo

• Ukhuseleko kwigumbi lokuhlambela kubantu abadala
• Ukuhlala kukhathalelo lwecatheter
• Ukuzivocavoca kukaKegel-ukuzikhathalela
• Prostate brachytherapy - ukukhutshwa
• I-radical prostatectomy-ukukhutshwa
• Unonophelo lwe-catheter ye-Suprapubic
• Unonophelo lwenxeba lotyando - luvulekile
• Iimveliso zokungahambelani nomchamo-ukuzikhathalela
• Iingxowa zokuhambisa umchamo
• Xa unesicaphucaphu nokugabha
• Xa une-incontinence yomchamo

UBhili-Axelson A, Holmberg L, Garmo H, et al. I-radical prostatectomy okanye ulinde ukulinda kumhlaza wesibeletho sokuqala. N Engl J Med. Ngo-2014; 370 (10): 932-942. IINKCUKACHA: 24597866 www.ncbi.nlm.nih.gov/pubmed/24597866.

U-Ellison JS, u-C, u-Wood DP. Umsebenzi wokuqala wokuchama kunye nowesondo uqikelela ukubuyela kwimeko yesiqhelo kunyaka omnye emva kweprotatectomy. J Urol. Ngo-2013; 190 (4): 1233-1238. IINKCUKACHA: 23608677 www.ncbi.nlm.nih.gov/pubmed/23608677.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lwe-Prostate cancer (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/prostate/hp/prostate-kunyanga-pdq. Ukuhlaziywa ngoJanuwari 29, 2020. Ifikeleleke ngoFebruwari 20, 2020.

Ukulahla kwakhona uMJ, uKoyama T, uFan KH, et al. Iziphumo ezisebenzayo zexesha elide emva konyango lomhlaza webele wendlala. N Engl J Med. Ngo-2013; 368 (5): 436-445. IINKCUKACHA: 23363497 www.ncbi.nlm.nih.gov/pubmed/23363497.

I-Schaeffer EM, i-Partin AW, i-Lepor H. Vula i-radical prostatectomy. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ii-eds. UCampbell-Walsh Urology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2016: isahluko 114.

ISu LM, uGilbert SM, uSmith JA. I-laparoscopic kunye ne-robotic encediswa yi-laparoscopic radical prostatectomy kunye ne-pelvic lymphadenectomy. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ii-eds. UCampbell-Walsh Urology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2016: isahl 115.