I-Cervical Dysplasia

I-Cervical Dysplasia yisimo esivamile sezifo zabesifazane esibandakanya izinguquko ezingavamile kumaseli asondelene nomlomo wesibeletho futhi okungase kubangele umdlavuza womlomo wesibeletho uma kungelashwa. Lesi simo esiyingozi sithinta izigidi zabesifazane emhlabeni jikelele. Ukuqonda i-dysplasia yomlomo wesibeletho, izimpawu zayo, kanye nokwelashwa okutholakalayo kubalulekile empilweni nasenhlalakahleni yabesifazane.

Kulesi sihloko, sizohlola ukungena nokuphuma kwe-dysplasia yomlomo wesibeletho. Sizoxoxa ngezimpawu nezimpawu ze-cervical dysplasia, sikhanyise ngezimbangela zayo, futhi sichaze ukuthi odokotela basihlola kanjani lesi simo. 

Iyini i-Cervical Dysplasia?

I-Cervical dysplasia yisimo esiyingozi esibonakala ngokukhula okungavamile kwamangqamuzana ebusweni bomlomo wesibeletho, ukuvuleka kwesibeletho. Kwaziwa nangokuthi i-cervical intraepithelial neoplasia (CIN) noma i-squamous intraepithelial lesion (SIL). Lesi simo ngokuvamile sibangelwa ukutheleleka ngezinhlobo ezithile ze-human papillomavirus (HPV), isifo esithathelwana ngocansi esivame kakhulu (STI). 

I-Cervical dysplasia ingathinta abantu abathanda ucansi abanomlomo wesibeletho, okuhlanganisa nabesifazane be-cisgender, amadoda ashintsha ubulili, nabantu abangazalwanga. Ubukhulu be-dysplasia yomlomo wesibeletho buyahlukahluka, kusukela kokuncane kuye kokuqina, kuye ngezinga lokukhula kwamaseli okungavamile. Nakuba kungewona umdlavuza ngokwawo, i-dysplasia yomlomo wesibeletho inamandla okuba umdlavuza uma ishiywe inganakiwe. Kodwa-ke, kubalulekile ukukhumbula ukuthi izimo eziningi azithuthukeli kumdlavuza, futhi ngokuqapha nokwelashwa okufanele, odokotela bangasilawula ngempumelelo lesi simo.

Izimpawu ze-Cervical Dysplasia

I-Cervical dysplasia ngokuvamile ayibonisi izimpawu eziphawulekayo, okwenza ukuhlolwa okuvamile kubalulekile ukuze kutholakale ngokushesha. Kodwa-ke, abanye abantu bangase babe nezimpawu ezilandelayo ze-cervical dysplasia:

• Okungajwayelekile ukopha kwesitho sangasese sowesifazane, njengokopha phakathi kokuya esikhathini, ngemva kokuya ocansini, noma ngemva kokunqamuka kokuya esikhathini 
• okungajwayelekile ukuqunjelwa sangasese (amanzi, anegazi, noma anuka kabi) 
• Ubuhlungu be-pelvic noma ukungakhululeki ngesikhathi socansi 

Kubalulekile ukuqaphela ukuthi lezi zimpawu ze-dysplasia yomlomo wesibeletho zingabonisa nezinye izimo, ngakho ukuhlolwa okufanele kwezokwelapha kubalulekile ukuze kutholakale ukuxilongwa okunembile. Ama-Pap smear ajwayelekile kanye nokuhlolwa kwe-HPV kudlala indima ebalulekile ekuhlonzeni i-dysplasia yomlomo wesibeletho ngaphambi kokuba idlulele ezigabeni ezinzima kakhulu noma okungenzeka ibe umdlavuza womlomo wesibeletho.

Izimbangela ze-Cervical Dysplasia

Imbangela eyinhloko ye-dysplasia yomlomo wesibeletho ukutheleleka ngezinhlobo ezithile ze-human papillomavirus (HPV). Nakuba kunezinhlobo eziningi ze-HPV, izinhlobo ezimbalwa kuphela ezisengozini enkulu ezingaholela ku-dysplasia yomlomo wesibeletho kanye nomdlavuza ongase ube khona womlomo wesibeletho. 

Ezinye izici ezingase zibe nomthelela ekuthuthukiseni i-dysplasia yomlomo wesibeletho zihlanganisa:

• Umlando womndeni womdlavuza womlomo wesibeletho
• Ukubhema
• Isivikelo somzimba sokuzivikela
• Ukusetshenziswa isikhathi eside kwemithi yokuvimbela inzalo ngomlomo
• Abalingani bocansi abaningi
• Ukuba nomlingani ocansini oseke waba nabalingani bocansi abaningi

Kubalulekile ukuqaphela ukuthi ukuba ne-HPV akuqinisekisi ukuthuthukiswa kwe-dysplasia yomlomo wesibeletho. Abantu abaningi abane-HPV abalokothi babe nezimpawu noma izinkinga zempilo. 

Izingozi ze-Cervical Dysplasia

Izici eziningana zandisa amathuba okuthuthukisa i-dysplasia yomlomo wesibeletho. 

• Ukutheleleka nge-Human papillomavirus (HPV) kuyisici esiyingozi esihamba phambili, ikakhulukazi izinhlobo ezinobungozi obuphezulu njenge-HPV-16 ne-HPV-18. 
• Ukuya ocansini usemncane noma ukuba nabalingani abaningi bocansi nakho kuphakamisa ingcuphe. 
• Ukubhema imikhiqizo kagwayi kungaphinda kabili amathuba e-dysplasia yomlomo wesibeletho.
• Amasosha omzimba abuthakathaka, kungakhathaliseki ukuthi kungenxa HIV/AIDS noma imishanguzo ye-immunosuppressive, yenza abantu babe sengozini enkulu. 
• Ezinye izici zihlanganisa umlando wezifo ezithathelwana ngocansi kanye nokungondleki kahle (ikakhulukazi ukuncipha kwezithelo nemifino). 

Ukuxilongwa kwe-Cervical Dysplasia

Odokotela ngokuvamile bathola i-dysplasia yomlomo wesibeletho ngesikhathi se-Pap smear evamile. Uma amaseli angajwayelekile etholakala, kungase kudingeke ukuhlolwa okwengeziwe, okuhlanganisa: 

• I-Colposcopy: A umbala ivumela odokotela ukuthi bahlole umlomo wesibeletho besebenzisa insimbi ekhanyisiwe ebizwa ngokuthi i-colposcope. Phakathi nale nqubo, bangase benze i-biopsy ukuze baqoqe amasampula ezicubu ukuze ahlaziywe elabhorethri. 
• Ukuhlolwa kwe-DNA: Bangakwazi ukubona izinhlobo ze-HPV eziyingozi kakhulu.

Ezimweni ezimbi kakhulu, odokotela bangancoma ukuhlolwa okwengeziwe:

• Iluphu yocingo lukagesi: Kule nqubo, udokotela usebenzisa intambo encane, enevoltage ephansi ukuze athathe isampula lethishu elincane.
• I-Cone Biopsy (I-Colonisation): Ivumela izendlalelo ezijulile zamaseli omlomo wesibeletho ukuthi ziqoqwe ukuze zihlolwe.
• I-Biopsy: Ngezinye izikhathi, odokotela bangase benze i-biopsy ukuze baqinisekise ukuxilongwa. Imiphumela ye-Biopsy ihlukanisa i-dysplasia yomlomo wesibeletho njenge-cervical intraepithelial neoplasia (CIN), ehlelwe izigaba ezintathu ngokusekelwe ebukhulwini:
  • I-CIN 1: I-dysplasia yezinga eliphansi 
  • I-CIN 2: I-dysplasia ye-intraepithelial emaphakathi
  • I-CIN 3: I-dysplasia enzima

Ukwelashwa kwe-Cervical Dysplasia

Ukwelashwa kwe-dysplasia yomlomo wesibeletho kuncike ezintweni ezihlukahlukene, kuhlanganise nobunzima, ubudala, impilo, kanye nezintandokazi zomuntu siqu. 

Nge-dysplasia yezinga eliphansi (CIN 1), odokotela bavame ukusebenzisa indlela yokulondoloza, njengoba izimo eziningi zixazulula ngokwabo. Ama-Pap smear ajwayelekile aqapha noma yiziphi izinguquko kumaseli angajwayelekile.

Ezimweni ezimbi kakhulu (CIN 2 noma CIN 3), odokotela bangasusa noma bacekele phansi amaseli angajwayelekile besebenzisa izinqubo ezifana nalezi:

• I-Loop Electrosurgical Excision Procedure (LEEP): Le nqubo isebenzisa iluphu yentambo eshajwe ngogesi ukuze isuse izicubu ze-dysplastic.
• I-Cold Knife Cone Biopsy (I-Colonisation): Isusa ucezu lwesicubu esimise okwekhoni esinamaseli angavamile.
• I-Cryosurgery: Imisa amaseli angavamile.
• I-Laser Surgery: Le ndlela isebenzisa i-laser ukususa izicubu ezingavamile.
• Ukuhlinzwa: Ezimweni eziqhubekayo, odokotela bangancoma i-hysterectomy. 

Ngemuva kokwelashwa kwe-dysplasia yomlomo wesibeletho, ukuhlolwa kokulandelela kuyadingeka, okuhlanganisa ukuphinda ukuhlolwa kwe-Pap noma ukuhlolwa kwe-HPV DNA.

Izinkinga ze-Cervical Dysplasia

I-dysplasia yomlomo wesibeletho, uma ishiywe ingalashwa, ingaholela ezinkingeni ezinkulu zezempilo, njenge: 

• Inkinga ebaluleke kakhulu ukukhula okungenzeka komdlavuza womlomo wesibeletho. Lokhu kuqhubekela phambili kungathatha iminyaka eminingana, kubukela phansi ukubaluleka kokuhlolwa okuvamile.
• Enye inkinga ihilela ukuzala futhi ukukhulelwa. Ukwelashwa okuthile kwe-dysplasia yomlomo wesibeletho, njenge-cone biopsy noma i-LEEP, kungase kwenyuse kancane amathuba okuzalwa okunesisindo esiphansi noma ukuzalwa ngaphambi kwesikhathi ekukhulelweni okuzayo. Nokho, lezi zingozi ngokuvamile ziphansi, futhi abesifazane abaningi bangakwazi ukukhulelwa okuphumelelayo ngemva kokwelashwa.
• I-Cervical dysplasia ingabangela ukucindezeleka kwengqondo. Ukuxilongwa kungase kuholele ekukhathazekeni ngempilo yesikhathi esizayo kanye nokuzala, kuthinte inhlalakahle yomuntu jikelele.

Uzoyibona Nini Udokotela

Abesifazane kufanele babonane nodokotela ukuze bahlolwe njalo umdlavuza womlomo wesibeletho, njengoba i-dysplasia yomlomo wesibeletho ngokuvamile ingabangeli izimpawu. Odokotela ngokuvamile bathola lesi simo ngesikhathi sokuhlolwa kwe-Pap okujwayelekile. Ngemuva kokuxilongwa kwe-dysplasia yomlomo wesibeletho, odokotela baqapha iziguli eduze ukuze baqinisekise ukuthi amaseli angajwayelekile awakhuli kabusha noma abe nomdlavuza. Bangase batuse ama-Pap smear kaningi kanye nokuhlolwa kwe-HPV. Ngemva kokwelashwa, iziguli zivame ukwenza ama-Pap smear okulandelela njalo ezinyangeni ezintathu kuya kweziyisithupha onyakeni owodwa kuya kwemibili.

Ngemva kwalokho, bangaphinda baqale ukuhlolwa kwe-Pap kwaminyaka yonke. Kubalulekile ukuya kuzo zonke izikhathi zokulandelela, njengoba i-dysplasia yomlomo wesibeletho engaxilongwa noma engelashwa yandisa ingozi yokuthuthukisa umdlavuza wesibeletho.

Prevention

• Ukuvimbela i-dysplasia yomlomo wesibeletho kuhilela ukugwema ukutheleleka nge-HPV. Indlela ephumelela kakhulu ukugoma i-HPV. Le mithi yokugoma iqondise ezinhlotsheni ze-HPV ezihlotshaniswa kakhulu nomdlavuza womlomo wesibeletho futhi umgomo ungathathwa yinoma ubani oneminyaka ephakathi kweyisi-9 nengama-45 ubudala. 
• Ukuhlolwa njalo komdlavuza womlomo wesibeletho, okuhlanganisa i-Pap smear nokuhlolwa kwe-HPV, kubalulekile. Abesifazane kufanele benze i-Pap smear yabo yokuqala lapho beneminyaka engu-21 futhi balandele izikhathi zokuhlola ezinconyiwe. 
• Ukwenza ucansi oluphephile, okuhlanganisa ukusebenzisa amakhondomu kanye nokukhawulela ozakwethu, kunganciphisa ingozi yokudluliselwa kwe-HPV. 
• Ukugwema ukusebenzisa ugwayi nakho kubalulekile, njengoba ukubhema kwandisa ingozi ye-dysplasia yomlomo wesibeletho iqhubekele ezinhlotsheni ezinzima kakhulu.

Isiphetho

I-Cervical Dysplasia inethonya elikhulu empilweni yabesifazane, idinga ukunakwa kanye nezinyathelo ezisebenzayo. Isixhumanisi sesimo sokutheleleka nge-HPV sigcizelela ukubaluleka kokugoma kanye nemikhuba yocansi ephephile ukuze kwehliswe ingozi. Ukuhlolwa njalo, ukuxhumana ngokukhululekile nodokotela, kanye nokwamukela indlela yokuphila enempilo kuyizinyathelo ezibalulekile zokuvikela i-dysplasia yomlomo wesibeletho kanye nezinkinga zayo ezingaba khona. Le ndlela yokuthatha isinyathelo ngokushesha ayigcini nje ngokuvikela impilo yomuntu ngamunye kodwa futhi ifaka isandla emizamweni ebanzi yokunciphisa izehlakalo zomdlavuza womlomo wesibeletho. Ukuzinika amandla ngolwazi mayelana ne-dysplasia yomlomo wesibeletho kuyisihluthulelo sokugcina impilo yomlomo wesibeletho. 

FAQ sika

1. Ingabe i-HPV ibangela i-dysplasia yomlomo wesibeletho?

Yebo, i-dysplasia yomlomo wesibeletho ngokuyinhloko ibangelwa ukutheleleka ngezinhlobo ezithile ze-human papillomavirus (HPV). I-HPV 16 ibophezeleka ku-50% wezigameko zomdlavuza womlomo wesibeletho, kanti ezinye izinhlobo ezisengozini enkulu zihlanganisa i-HPV 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, kanye nama-68.

2. Kuthinta bani?

I-Cervical dysplasia ithinta abantu abathanda ucansi abanomlomo wesibeletho, okuhlanganisa nabesifazane be-cisgender, amadoda ashintshe ubulili, kanye nabantu abangazalwanga. Ivame kakhulu kwabesifazane abaneminyaka engaphansi kuka-30 kodwa ingakhula kunoma iyiphi iminyaka.

3. Uyini umehluko phakathi kwe-cervical dysplasia kanye ne-HPV?

I-Human papillomavirus (HPV) igciwane elidala i-dysplasia yomlomo wesibeletho. Nakuba ukutheleleka kwe-HPV kuvamile, akuzona zonke izimo eziholela ku-dysplasia yomlomo wesibeletho. Amasosha omzimba avame ukuqeda izifo ze-HPV, kodwa izifo ezingapheli zingaholela ekukhuleni kwamangqamuzana okungavamile.

4. Ingabe i-dysplasia yomlomo wesibeletho ibucayi?

I-Cervical Dysplasia yisimo esiyingozi esingaba umdlavuza womlomo wesibeletho uma singelashwa. Kodwa-ke, izimo eziningi azithuthukeli kumdlavuza, ikakhulukazi ngokuqapha nokwelashwa okufanele.

5. Ingabe i-dysplasia yomlomo wesibeletho iwumdlavuza?

Yebo, i-dysplasia yomlomo wesibeletho ibhekwa njengesimo esiyingozi. Kubandakanya ukukhula kwamaseli okungavamile endaweni yomlomo wesibeletho kodwa akukabi umdlavuza. Uma ingelashwa, maningi amathuba okuthi ikhule ibe umdlavuza womlomo wesibeletho ngokuhamba kwesikhathi.

6. Ingabe umdlavuza womlomo wesibeletho uyelapheka?

Yebo, i-precancer yomlomo wesibeletho ngokuvamile iyelapheka. Ukukhipha noma ukucekela phansi amaseli angavamile kwelapha i-dysplasia yomlomo wesibeletho cishe ku-90% wezimo. Izinketho zokwelapha zihlanganisa i-LEEP, i-cryosurgery, ukuhlinzwa kwe-laser, futhi, kwezinye izimo, hysterectomy.

7. Yisiphi isikhathi sokululama sokuhlinzwa kwe-cervical dysplasia?

Isikhathi sokuthola kabusha siyahlukahluka ngokuya ngenqubo. I-LEEP, ukwelashwa okuvamile, ngokuvamile ivumela iziguli ukuthi ziqale kabusha imisebenzi evamile phakathi nezinsuku ezimbalwa. Kodwa-ke, ukunakekelwa kokulandelela kanye nokuhlolwa okuvamile kubalulekile ukuze kuqashwe ukuphindeka.

UDkt.Muthineni Rajini

I-MBBS, i-DGO, i-DNB, i-FICOG, i-ICOG, Izifundo eziqinisekisiwe ze-Endoscopy ye-Gynecological
CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

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