I-Endometrial Hyperplasia

I-Endometrial hyperplasia yisimo esithinta ulwelwesi lwesibeletho, okwenza lujiye ngendlela engavamile. Lokhu kuqina okungavamile kodonga lwesibeletho kunomthelela kwabesifazane abaningi emhlabeni wonke futhi kungaholela ekukhathazekeni okukhulu kwezempilo uma kungelashwa. Ukuqonda i-endometrial hyperplasia kubalulekile ekutholakaleni kusenesikhathi nokuphathwa ngempumelelo, njengoba kwesinye isikhathi ingathuthukela ezimeni ezinzima kakhulu. 

Lesi sihloko sihlola izici ezibucayi ze-endometrial hyperplasia ukusiza abafundi baqonde kangcono lesi simo. 

Iyini i-Endometrial Hyperplasia? 

I-Endometrial hyperplasia ithinta ulwelwesi lwesibeletho (i-endometrium), ibangele ukuthi lube lukhulu ngendlela engavamile. Lokhu kwanda kwe-endometrium kuvame ukubangelwa ukungalingani kwamahomoni futhi kungabangela izimpawu ezingakhululekile kwabesifazane. Lesi sibeletho se-hyperplasia sivame ukwenzeka kwabesifazane abaseduze menopause (sekupheleni kweminyaka engu-40 no-50), kodwa kungathinta nabesifazane abasebasha. Nakuba ungewona umdlavuza ngokwawo, lesi simo ngezinye izikhathi singadlulela kumdlavuza we-endometrial uma singelashwa. 

Izinhlobo ze-Endometrial Hyperplasia 

Uhlelo lwe-World Health Organisation luka-2014 luhlukanisa i-endometrial hyperplasia ibe izigaba ezimbili eziyinhloko: 

• Uhlobo lokuqala yi-hyperplasia ngaphandle kwe-atypia, eyaziwa nangokuthi i-benign endometrial hyperplasia. Leli fomu linamaseli abukeka ngendlela evamile kanye nengozi ephansi yokuba nomdlavuza. Ivame ukuphendula kahle ekwelashweni kwe-hormonal noma ingase ithuthuke ngaphandle kokungenelela. 
• Uhlobo lwesibili yi-atypical hyperplasia, ebizwa nangokuthi i-endometrial intraepithelial neoplasia. Leli fomu linamaseli angavamile futhi linethuba eliphezulu lokuqhubekela phambili umdlavuza we-endometrial. 

Izimpawu ze-Endometrial Hyperplasia 

• Ukopha okungavamile kwesibeletho iphakathi kwezimpawu ezivame kakhulu ze-endometrial hyperplasia. 
• Abesifazane bangase bezwe igazi elinzima lokuya esikhathini noma ukopha phakathi nokuya esikhathini. 
• Imijikelezo emifushane yokuya esikhathini, ehlala isikhathi esingaphansi kwezinsuku ezingama-21, nayo ingabonisa lesi simo. 
• Ukopha kwangemva kokuya esikhathini kungolunye uphawu olubalulekile oludinga ukunakekelwa kwezokwelapha ngokushesha. 

Izinkinga ze-Endometrial Hyperplasia 

I-Endometrial hyperplasia ngokuyinhloko ibangelwa ukungalingani phakathi kwamahomoni e-estrogen ne-progesterone. Lesi simo sithinta ulwelwesi lwesibeletho, silwenze lujiye ngendlela engavamile. Isizathu esiyinhloko i-estrogen eyeqile ngaphandle kwe-progesterone eyanele yokubhekana nemiphumela yayo. Lokhu kungalingani kwe-hormonal kuvame ukwenzeka ngesikhathi sokunqamuka kokuya esikhathini noma ukuya esikhathini lapho nge-ovulation iba ngokungajwayelekile noma ime ngokuphelele. Ezinye izimbangela zokuqina kwe-endometrium yizimo zabesifazane kanye nemithi, njenge-tamoxifen esetshenziswa ekwelapheni umdlavuza webele. 

Izingozi Zezingozi 

Kunezici eziningana ezandisa amathuba okuthuthukisa i-endometrial hyperplasia, okuhlanganisa: 

• Iminyaka yobudala idlala indima ebalulekile, kanti abesifazane abangaphezu kweminyaka engama-35 babhekene nengozi enkulu. 
• Ukukhuluphala kunomthelela omkhulu, njengoba amafutha amaningi emzimbeni ashukumisa ukukhiqizwa kwe-estrogen. 
• I-anovulation engapheli, evame ukuhlotshaniswa ne-polycystic ovary syndrome (PCOS), inomthelela ekungalingani kwamahomoni. 
• Ukuya esikhathini ngaphambi kwesikhathi kanye nokunqamuka kokuya esikhathini sekwephuzile kwandisa isikhathi sokuchayeka kwe-estrogen. 
• Izimo ezithile zezokwelapha, njengesifo sikashukela nesifo se-thyroid, nazo ziphakamisa ingozi. 
• Ukwelashwa kokubuyisela ama-hormone kusetshenziswa i-estrogen kuphela kwabesifazane abangemva kokuya esikhathini abanesibeletho esiqinile kuba nomthelela ekuthuthukisweni kwalesi simo. 

Izinkinga 

• Ukukhathazeka okubaluleke kakhulu ukuthuthukiswa okungenzeka komdlavuza we-endometrial, ikakhulukazi ezimeni ze-endometrial hyperplasia. I-hyperplasia ye-endometrial engelashiwe inethuba eliphezulu lokuba nomdlavuza, kuze kufike ku-30% ezimo eziyinkimbinkimbi ezidlulela kumdlavuza ngaphandle kokwelashwa. 
• Enye inkinga i-anemia engapheli, ebangelwa ukopha okungavamile nokopha kakhulu. Lesi simo sinomthelela empilweni yonke, okubangela ukukhathala nokukhubazeka nokusebenza komzimba. 
• Ukwengeza, i-endometrial hyperplasia ingakhuphula ukungalingani kwe-hormonal, okungase kuholele ezinkingeni zempilo yokuzala. 

Ukuxilongwa kwe-Endometrial Hyperplasia 

Odokotela baxilonga i-endometrial hyperplasia ngokuhlola umlando wezokwelapha nezimpawu kanye nokwenza izivivinyo zokuxilonga. 

• I-Transvaginal Ultrasound: Lokhu kuhlolwa kokuxilonga kusiza ukubona ukuthi ulwelwesi lwesibeletho lujiyile kunokujwayelekile. 
• I-Biopsy: Uma kutholakala ukuqina, odokotela bangancoma i-biopsy ukuze baqinisekise ukuxilongwa. 
• Izinqubo: Ngezinye izikhathi, izinqubo ze-dilation and curettage (D&C) noma i-hysteroscopy zingadingeka. Lokhu kuvumela udokotela ukuthi abone isibeletho futhi akhiphe isampula yolwelwesi. 

Ukwelashwa kwe-Endometrial Hyperplasia 

Odokotela bavame ukutusa ukwelashwa kwe-progestin ukuze kulinganisele imiphumela ye-estrogen ohlelweni. Le ndlela yehlisa ukopha okungavamile futhi inciphisa ingozi yokukhula komdlavuza. Izinketho zifaka amaphilisi okulawula ukuzalwa, imijovo ye-progestin, amakhilimu e-vaginal, namadivayisi we-intrauterine akhulula i-levonorgestrel. 

Kwabesifazane abane-hyperplasia ye-atypical noma labo asebeqedile ukuzala, odokotela bangase bacebise ukungenelela kokuhlinzwa, izinqubo zokuhlanjululwa kanye nezinqubo zokuphulukisa (D&C) noma i-hysteroscopy. 

Uzoyibona Nini Udokotela 

Abesifazane kufanele bafune usizo lwezokwelapha uma bebona izinguquko endleleni abaya ngayo esikhathini. Lokhu kufaka phakathi izikhathi ezinzima kakhulu noma ezihlala isikhathi eside, imijikelezo yokuya esikhathini emifushane kunezinsuku ezingama-21, noma ukopha ngemva kokunqamuka kokuya esikhathini. Lezi zimpawu zingase zibonise i-endometrial hyperplasia. 

Abesifazane abaneminyaka engu-35 noma ngaphezulu abopha ngendlela engavamile kufanele bathintane nodokotela wabo wokubelethisa- udokotela wezifo zabesifazane ukuhlolwa kokuxilonga. 

Abesifazane abasebancane ukopha kwabo okungavamile kungakathuthuki ngemithi kufanele nabo bafune iseluleko sezokwelapha. Ukudluliselwa okuphuthumayo kusevisi yomdlavuza wezifo zabesifazane kuyadingeka kwabesifazane abangaphezu kweminyaka engama-55 ababona ukopha kwangemva kokuya esikhathini. 

Prevention 

Ukuvimbela i-endometrial hyperplasia kuhilela ukubhekana nezici zengozi eziguquguqukayo. 

• Isisindo esinempilo singanciphisa ingozi yalesi simo. Abesifazane abakhuluphele ngokweqile noma abakhuluphele ngokweqile kufanele bakhuthazwe ukuba behlise isisindo ngokudla kanye nokuzivocavoca. 
• Ukuzivivinya umzimba njalo, ngisho nokukhanya kuya kokumaphakathi, kusiza ekwehliseni ubungozi. 
• Ibhalansi ye-Hormonal idlala indima ebalulekile ekuvimbeleni. Abesifazane abasebenzisa i-estrogen ngemva kokunqamuka kokuya esikhathini kufanele futhi baphuze i-progestin noma i-progesterone ukuze balwe nemiphumela ye-estrogen. 
• Ukugwema iziphuzo ezinoshukela kanye nokudla okunomthwalo ophezulu we-glycemic kungasiza ekuvimbeleni i-endometrial hyperplasia. 

Isiphetho 

I-Endometrial hyperplasia inomthelela omkhulu empilweni yabesifazane, ithinta ulwelwesi lwesibeletho futhi okungase kuholele ezinkingeni ezinzima. Lesi simo sibangelwa ukungalingani kwama-hormone, ngokuyinhloko i-estrogen eyeqile ngaphandle kwe-progesterone eyanele ukuze imelane nemiphumela yayo. Ukuthola ulwazi lwezinhlobo, izimpawu zokujiya kwe-endometrial, izimbangela, kanye nezici zobungozi ezihlobene ne-endometrial hyperplasia kubalulekile ekubonweni kusenesikhathi nokuphatha ngempumelelo. Ukunakwa ngokushesha kanye nokwelashwa okufanele kunomthelela ekuvimbeleni ukuqhubekela phambili ezimeni ezinzima kakhulu, okuhlanganisa nomdlavuza we-endometrial. 

FAQ sika 

1. Ingabe i-endometrial hyperplasia inzima? 

I-Endometrial hyperplasia ingaba nzima, ikakhulukazi uma ishiywe ingalashwa. I-Atypical endometrial hyperplasia iphakamisa ingozi yomdlavuza we-endometrial & wesibeletho. 

2. Uyisusa kanjani i-endometrial hyperplasia? 

Izinketho zokwelapha ze-Endometrial thickening zihlanganisa amaphilisi okulawula ukuzalwa, imijovo ye-progestin, amakhilimu e-vaginal, namadivayisi we-intrauterine akhulula i-levonorgestrel. Kwabesifazane abane-hyperplasia ye-atypical noma labo asebeqedile ukuzala, i-hysterectomy ingase ibhekwe njengokuqeda amathuba okuthuthukiswa komdlavuza we-endometrial. 

3. Ingabe ukujiya kwe-endometrial okungu-1.5 cm kujwayelekile? 

Ubukhulu be-Endometrial buyahlukahluka phakathi nomjikelezo wokuya esikhathini kanye nobudala. Ngokuvamile: 

• Kwabesifazane abangaphambi kokuya esikhathini ngesikhathi semfihlo yomjikelezo wokuya esikhathini), u-1.5 cm ungaba ojwayelekile. 
• Kwabesifazane abangemva kokunqamuka kokuya esikhathini, ugqinsi olungaphezu kuka-0.5 cm lungadinga uphenyo olwengeziwe 

4. Yini ongayigwema uma une-endometrial hyperplasia? 

Uma kutholakala ukuthi une-endometrial hyperplasia: 

• Gwema ukuchayeka ngokweqile kwe-estrogen (okuhlanganisa amakhambi athile nezithako) 
• Nciphisa ukudla okugayiwe kanye noshukela ocolisisiwe 
• Yehlisa ukusetshenziswa kotshwala 
• Gwema ukubhema 
• Nciphisa ukuchayeka kubuthi bemvelo 
• Gwema ukubambezela ukwelashwa noma ukuziba izimpawu 

5. Ingabe i-endometrium ejiyile ingelapheka? 

Yebo, i-endometrium ejiyile ngokuvamile ingelashwa ngokuphumelelayo: 

• Ukwelashwa ngama-Hormonal (isb, ukwelashwa kwe-progestin) 
• Izinguquko zokuphila 
• Kwezinye izimo, ukungenelela kokuhlinzwa okufana ne-D&C noma i-hysterectomy 
• Ukuqapha njalo nokulandelela odokotela 

UDkt. Neha V Bhargava

MS, DNB (obgyn), MNAMS, Fellow (Gynae Oncology)
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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