Ama-Froid amantombazane

Ukwelashwa kwe-Uterine Fibroids e-Hyderabad

I-Uterine Fibroids, eyaziwa nangokuthi i-Uterine Myoma ukukhula kwezimila ezingenawo umdlavuza ezikhula esibelethweni sowesifazane. Ama-fibroids akhiwa ngaphandle kwemisipha yesibeletho kanye nezicubu ezixhumeneyo. Ekwaziwa nangokuthi 'i-leiomyomas', kuyilapho lezi zimila zingahlobene ngokuqondile nokuba nomdlavuza, zingabangela ukuguquguquka okuhlukahlukene emzimbeni wesifazane kuye ngosayizi wazo. 

Ngaphezu kobukhulu, ukuma, nendawo esibelethweni, ngisho nenani lama-fibroids linomthelela oqondile emthelela omude emzimbeni. Usayizi uyahluka ukusuka kokucishe ungabonakali kuya ekubeni yisakhiwo esinesisindo esinjengesiqu, sinwebeka kuze kufike ku-ribcage. Ama-fibroids angatholakala odongeni lwesibeletho sowesifazane, ngaphakathi kwesibeletho, noma ngisho nangaphandle kwayo. 

I-Fibroids yinto evamile ebonwa emzimbeni wesifazane kunoma iyiphi iminyaka enikeziwe kodwa itholakala kakhulu esimweni seminyaka yokuzala. 

Izimpawu

Uma kubhekwa ukuthi ama-fibroids awanawo umthelela oqinile emzimbeni wesifazane okungukuthi awabonisi zimpawu ezisheshayo ezigabeni zokuqala, cishe akunakwenzeka ukuxilonga okufanayo ngakunye. Eqinisweni, abesifazane abaningi bangase baqukathe lezi fibroids isikhathi sabo sokuphila kodwa bangase bangazi ngakho kuze kube sekupheleni. Kunconywa ukuhlolwa kwe-pelvic noma i-prenatal ultrasound ukuze uqaphele lesi simo. 

Noma kunjalo, esimweni sokusakazeka okungavamile- kwama-nodule amagatsha amaningi, izimpawu ezimbalwa ezivame ukubonwa, zimi kanje:

• Ukopha okuminyene kokuya esikhathini

• Umjikelezo wokuya esikhathini eside/owandisiwe (wokopha).

• Ubuhlungu be-pelvic nokungakhululeki

• Ukuchama njalo noma ukuthambekela kokuchama

• Isisu esibi nokuqunjelwa

• Ubuhlungu beqolo kanye nemisipha yomlenze obuhlungu

• Ukugcinwa kwe-Urinary

Ngokuvamile zihlukaniswa ngendawo yazo ezine-Intramural fibroids (ezivame kakhulu) ezivela ngaphakathi kodonga lwemisipha, i-Subserosal fibroids yakheka ngaphandle kwesibeletho (serosa), i-Pedunculated fibroids iyisandiso (njengesiqu) sama-subserosal, kanye nama-Submucosal fibroids akhula engxenyeni ephakathi eyaziwa ngokuthi i-myometrium yesibeletho. Kuzo zonke lezi, i-Submucosal iwuhlobo oluyivelakancane. Amaphethini okukhula alawa ma-fibroids nawo angahluka ukusuka kuphethini enensayo ukuya ekukhuleni okugxilile. Umuntu angaphinde alindele ushintsho (ngisho nokuncipha) kusayizi walezi fibroids.

Izimbangela 

Ucwaningo lwezokwelapha nolwazi lukhomba lezi zikhombisi-ndlela ezilandelayo zokudweba izimbangela ze-fibroids njengoba kungekho okutholakele okuqinile okufanayo-

• Umlando Womndeni kanye Nezakhi Zofuzo: Ngenxa yephethini emlandweni wofuzo, ama-fibroids angabonwa ahluke kumaseli emisipha yesibeletho evamile.

• Izici zeHormonal: Amahomoni amabili, i-Estrogen, ne-Progesterone asebenza njengezikhuthazi ekuvuseleleni ulwelwesi lwesibeletho ngomjikelezo ngamunye wokuya esikhathini nawo angase abe isikhuthazi ekukhuleni kwalezi fibroids. Uma kuqhathaniswa, ama-fibroids anamandla okwamukela i-estrogen ne-progesterone amaningi kunemisipha yesibeletho. Ukuthambekela kokuncipha kuyabonwa kubo ngemuva kwesigaba sokunqamuka kokuya esikhathini ngenxa yokulahlekelwa ukukhiqizwa kwamahomoni ngumzimba.

• Ukukhulelwa: Ama-fibroids angase athuthukiswe ngesikhathi sokukhulelwa njengoba umzimba uba nezinga elithuthukisiwe lokukhiqizwa kwamahomoni.

• Izinto Ezihlobene Nokukhula: Noma yiziphi izinto ezengeziwe ezingase ziguqule noma zisetshenziselwe ukulondoloza amazinga ehomoni namakhemikhali omzimba njenge-insulin nazo zingase zibe nesibopho ekukhuleni kwe-fibroid.

• I-matrix ye-Extracellular noma i-ECM: Ngokufana nokuhlelwa kwezitini nodaka, i-ECM iyinhlanganisela enesibopho sokuthi amaseli anamathele ndawonye. Futhi kusiza ushintsho ezicini zokukhula futhi ngaleyo ndlela kungabangela izinguquko eziphilayo kumaseli okuholela ekwakhekeni kwama-fibroids.

Izingozi Zezingozi

Ngaphandle komzimba wesifazane ngeminyaka yokuzala, ezinye zezinto ezigxile ebungozini ezaziwayo ukuthi zinomthelela kuma-fibroids yilezi ezilandelayo:

• Ubudala

Abesifazane asebekhulile baziwa njengabasengozini enkulu kunabesifazane abasebasha uma kwenzeka bethola ama-fibroids, kusho phakathi kweqembu leminyaka engu-30-40. Ukwengeza, ukuya esikhathini usemncane kunokuvamile kungase futhi kuphakamise umthelela wehomoni ongase ubonakale ngendlela yama-fibroids.

• Race

Umbuzo wesici esithile sofuzo esikhulisa ukuthambekela kokuthuthukiswa kwe-fibroids enzima uyaphakanyiswa kwabesifazane base-Afrika-baseMelika ngocwaningo.

• Izinyathelo Zokulawula Ukuzalwa

Izinyathelo zokulawula inzalo njengamaphilisi noma okufanayo okuholela ekushintsheni ukwakheka kwamahomoni omzimba kungase kuholele ekwakhekeni kwe-fibroid.

• Izingosi zemvelo 

Izici ezinjengokudla nemikhuba yokudla (ekhomba ekushiyekeni noma ngisho nezimo ezifana nokukhuluphala, okungukuthi, ezingekho ngaphansi kwesethi evamile yomzimba onempilo), umlando wokuhlukunyezwa okuholela ezimweni ezingokwengqondo eziphelele njengokucindezeleka noma ukukhathazeka kungaholela ekwandeni kwengozi yokuthuthukisa ama-fibroids. Ukuphuza utshwala nakho kungabhekwa njengento enomthelela kulesi simo.

• Umlando womndeni

Kuye kwaphawulwa endabeni yomlando womndeni olandelwayo ukuthi uma amalungu wesifazane ethi umama noma udadewabo womuntu uke waba nomlando we-fibroids, kungenzeka ukuthi umzimba walowo okukhulunywa ngaye ungaba nengozi enkulu noma ukuthambekela kokuthwala okufanayo. Lokhu kungabangelwa ukwakheka kwamangqamuzana nezici zomzimba emndenini.

Sifo

Ukubonisana nodokotela wakho wezifo zabesifazane kuzokusiza ukuthi ubone inkinga. Inqubo yokuxilongwa kwe-uterine fibroids ihlanganisa ukuhlolwa kwe-pelvic lapho udokotela wakho ezohlola isibeletho sakho noma yikuphi ukungahambi kahle ngobukhulu, ukuma, noma isimo. Ngemuva kokuhlolwa kwe-pelvic yakho, ungabuza udokotela wakho noma yimiphi imibuzo noma ukungabaza okungenzeka ube nakho mayelana ne-uterine fibroids. Ungaxoxa ngenani lama-fibroids, ubukhulu bawo, lapho atholakala khona uma ekhula ngokuhamba kwesikhathi, nokuthi yiziphi izinketho zakho zokwelapha. 

I-uterine fibroids ingase itholakale ngesikhathi sokuhlolwa kwe-pelvic okujwayelekile uma udokotela wakho ethola noma yikuphi ukungahambi kahle ngesikhathi sokubonisana. Uma udokotela wakho eseqinisekisa ubukhona be-uterine fibroids, angase acele ukuhlolwa okulandelayo ukuze uthole ukuxilongwa okufanele kwesimo sakho - 

• I-Ultrasound: I-ultrasound kuzoba ukuhlolwa kokuqala kokuxilonga udokotela wakho angase aku-odole ukuze aqinisekise ubukhona be-fibroids. I-ultrasound isebenzisa amaza omsindo ukuze ibonise isithombe sesibeletho sakho. Lokhu kungasiza udokotela wakho ukuthi akhombe, enze imephu, futhi alinganise usayizi wama-fibroids. I-ultrasound ingenziwa ngaphandle, lapho idivayisi ibekwe phezu kwesisu sakho noma ingaba i-ultrasound ye-transvaginal. 

• Ukuhlolwa kwegazi: Kanye nokuhlolwa kwezithombe njenge-ultrasound, udokotela wakho angase futhi akucele ukuba wenze ukuhlolwa kwegazi ukuze kutholakale imbangela yokwakheka kwama-fibroids. Ama-fibroids angabangela ukopha okungavamile kokuya esikhathini, okungaba inkomba ye-anemia ngenxa yokulahlekelwa igazi, ukuphazamiseka kwegazi, noma izinkinga ze-thyroid.

• Ukufaniswa kwe-Magnetic Resonance (MRI): Uma kwenzeka i-ultrasound inganele ukubheka kahle isibeletho sakho kanye nama-fibroids, udokotela wakho angase a-oda i-MRI scan ezobasiza ukuthi bayibheke kangcono le ndaba. Ukuhlolwa kuzobonisa imininingwane eyengeziwe mayelana nosayizi, ukukhula, kanye nokuma kwe-fibroids. 

• I-Hysterosonography: I-Hysterosonography yaziwa nangokuthi i-sonogram yokufaka usawoti osiza udokotela wakho abone ulwelwesi lwangaphakathi lwesibeletho. Kule nqubo yokuxilonga, amanzi anosawoti oyinyumba afakwa esibelethweni ukuze kubonakale kangcono izindonga zangaphakathi zesitho. Lokhu kuhlola kungabonisa noma yiziphi izinkinga ezingathi sína ezingase zenzeke ngenxa yama-fibroids njengokungazali ngenxa yama-fibroids avimba amashubhu e-fallopian. 

• I-Hysteroscopy: Le nqubo yokuxilonga ihlanganisa ukufakwa kwesisetshenziswa esifana nesibonakude emlonyeni wesibeletho esivumela udokotela ukuba ahlole ukuvuleka komlomo wesibeletho kanye nolwelwesi lwesibeletho. 

• I-Computed Tomography (CT) Scan: I-CT scan isebenzisa ama-X-ray ukuze idale izithombe ezinemininingwane yezitho zakho zangaphakathi ngama-engeli amaningi.

• I-Sonohysterography: Lokhu kuhlola kuhilela ukufaka ipayipi elincane esithweni sangasese sowesifazane kanye nokujova usawoti esibelethweni. Uketshezi olungeziwe lunikeza umbono ocacile wesibeletho uma kuqhathaniswa ne-ultrasound evamile.

• I-Laparoscopy: Kule nqubo, ukusika okuncane kwenziwa ngaphansi kwesisu. Ishubhu elincanyana nelithambile elinekhamera lifakwa ukuze lihlole ngokucophelela izitho zangaphakathi.

Ukwelashwa 

Kunezinketho ezahlukene zokwelapha ezitholakalayo ze-uterine fibroids. Inkambo yakho yokwelashwa ingase incike ezicini ezifana nenombolo, ubukhulu, nendawo ye-fibroid, iminyaka yakho, noma yiziphi izinkinga ezengeziwe ongase ube nazo, njll. Ungathintana nodokotela wakho wezifo zabesifazane mayelana nokwelashwa okutholakalayo kwe-uterine fibroids futhi nixoxe ngakho ngokuningiliziwe ngaphambi kokwenza noma yisiphi isinqumo. Ezinye zezindlela zokwelapha ezijwayelekile yilezi: 

1. Imithi

Imithi ye-uterine fibroids isebenza ngokukhomba amahomoni alawula umjikelezo wakho wokuya esikhathini. Basiza ukuphatha izimpawu ezifana nokopha kakhulu kanye nomfutho we-pelvic. Le mithi ayiwaqedi ama-fibroids kodwa ingasiza ukuwashwabanisa.

Izinhlobo zemithi zihlanganisa:

• Ama-agonists e-GnRH: Le mithi inciphisa amahomoni e-estrogen ne-progesterone, ikubeka esimweni esifana nokunqamuka kokuya esikhathini. Lokhu kumisa izikhathi, kunciphisa ama-fibroids, futhi kuthuthukise i-anemia. Izibonelo zifaka i-leuprolide (i-Lupron Depot), i-goserelin (i-Zoladex), ne-tritorelin (i-Trelstar). Imiphumela engemihle efana nokushisa okushisayo ivamile, futhi ukusetshenziswa isikhathi eside kungaholela ekulahlekelweni kwamathambo. Avamise ukusetshenziswa isikhathi esingekho ngaphezu kwezinyanga eziyisithupha kodwa angase ahlanganiswe ne-estrogen yomthamo ophansi noma i-progestin (ukwelashwa okwengeza emuva) ukuze kwehliswe imiphumela engemihle futhi andise ukusetshenziswa kufikela ezinyangeni eziyi-12. Odokotela bangase banikeze lokhu ukuze banciphise ama-fibroids ngaphambi kokuhlinzwa noma basize ukushintshela ekunqamukeni kokuya esikhathini.
• Abaphikisi be-GnRH: Le mithi ilawula ukopha okukhulu kubantu abangakafiki esikhathini sokuya esikhathini kodwa abanganciphisi ama-fibroids. Angasetshenziswa iminyaka efinyelela kwemibili, ngokuvamile ngokwelashwa okungeza emuva ukuze kuncishiswe imiphumela engemihle efana nokubanika okushisayo noma ukulahlekelwa amathambo.
• I-IUD ekhipha i-Progestin: Lo mshini ungasiza ekwehliseni ukopha okukhulu okubangelwa ama-fibroids, kodwa awushwabanisi ama-fibroids noma awasuse. Iphinde ivimbele ukukhulelwa.
• I-Tranexamic acid: Umuthi ongewona owe-hormonal othathwa ngezinsuku zokopha kakhulu ukuze unciphise ukugeleza kokuya esikhathini.
• Eminye imithi:
  • Amaphilisi okulawula inzalo anedosi ephansi: Ingasiza ekulawuleni ukopha kodwa ingashwabanisi ama-fibroids.
  • Ama-NSAID (isb, ibuprofen noma i-naproxen): Siza ngobuhlungu kodwa unganciphisi ukopha noma usayizi we-fibroid.
  • Amavithamini kanye nezithako ze-iron: Kunconyelwe labo abopha kakhulu kanye ne-anemia.

2. Ukwelashwa okungahlanyisi

Inqubo engahlaseli yokunciphisa usayizi we-fibroid ingaba inketho yokwelapha kuwe. Ekuhlinzweni kwe-ultrasound okuqondiswa yi-MRI, kusetshenziswa i-ultrasound transducer ngenkathi isiguli sisesithwebuli se-MRI ukuze sibone indawo eqondile yama-fibroids, namagagasi omsindo agxile kuleyo ndawo ukuze kushiswe ama-fibroids futhi ashwabane. Le nqubo ayihlaseli, ayidingi ukusikwa, igcina isibeletho sakho, futhi ingenziwa njengenqubo yokulaliswa esibhedlela.

3. Izinqubo Ezihlasela Kancane

Izinketho eziningi zezinqubo zokuhlasela kancane zingacatshangelwa ukuze kukhishwe noma kunciphe i-uterine fibroids. Inqubo yokubopha umthambo wesibeletho iyasebenza ekunciphiseni ama-fibroids. Ukugeleza kwegazi kuma-fibroids kumiswa ngokujova izinhlayiya ezincane ze-embolic emithanjeni ehambisa igazi esibelethweni. Lokhu kubangela ukuthi bashwabane futhi bafe futhi kuzosiza ekulawuleni nezinye izimpawu. Enye inqubo i-radiofrequency ablation, lapho amandla e-radiofrequency esetshenziselwa ukushwabanisa imithambo yegazi kuma-fibroids, ayibhubhise ngempumelelo. I-Laparoscopic noma i-robotic myomectomy iyinqubo lapho ukusika okuncane kwenziwa endaweni yesisu ukuze kukhishwe ama-fibroids. I-hysteroscopic myomectomy ingenziwa uma une-submucosal fibroids. Kule nqubo, amathuluzi afakwa esithweni sangasese sowesifazane kanye nomlomo wesibeletho ukuze afinyelele esibelethweni futhi akhiphe ama-fibroids. Ungase futhi ube nenketho yokukhishwa kwe-endometrial lapho ithuluzi lifakwa esibelethweni futhi ukushisa, amanzi ashisayo, amanzi ashisayo, noma ama-microwave kungase kusetshenziswe ukucekela phansi ulwelwesi lwesibeletho. Iningi labesifazane abathola le nqubo kungenzeka bangakwazi ukukhulelwa.

4. Inqubo Yokuhlinza 

Izinqubo zokuhlinza ezifana ne-myomectomy yesisu kanye ne-hysterectomy nazo zingacatshangelwa uma une-fibroids enkulu neningi elokhu ibuya naphezu kokuthola ezinye izinqubo. I-Abdominal Myomectomy ibhekisela ekuhlinzweni kwendabuko lapho odokotela bekhipha ama-fibroids esibelethweni. Le nqubo yokuhlinzwa ingase ibangele izibazi esibelethweni futhi ingase iphazamise amathuba akho okukhulelwa. Ngakolunye uhlangothi, i-Hysterectomy ibhekisela ekukhishweni okuphelele kwesibeletho futhi ukuphela kwekhambi elihlala njalo lokwelapha i-uterine fibroids. Xhumana nodokotela wakho ngaphambi kokwenza isinqumo sokuqhubeka ne-hysterectomy njengoba le nqubo ingunaphakade. 

5. Izinqubo Zokuhlinza Ngokwesintu

Izinketho zokuhlinzwa okuvulekile kwendabuko okubandakanya ukusika okukhulu kufaka:

• I-Myomectomy yesisu: Le nqubo isusa ama-fibroids ngokusika okukhulu endaweni yesisu. Ngokuvamile kunconywa kubantu abane-fibroids eminingi, ama-fibroids amakhulu kakhulu, noma ama-fibroids atholakala ekujuleni kwesibeletho. Nakuba kungase kube enye indlela yokuhlinzwa kwe-hysterectomy kwabanye, ukukhishwa kokuhlinzwa kungase kunciphise amathuba okukhulelwa esikhathini esizayo.
• I-Hysterectomy: Lokhu kuhlinzwa kuhilela ukukhipha isibeletho futhi ukuphela kokwelashwa okuqinisekile, okuhlala njalo kwe-uterine fibroids.
  • I-hysterectomy iqeda amandla okuba nezingane.
  • Uma ama-ovari nawo ekhishiwe, kubangela ukuyeka ukuya esikhathini, ngemva kwalokho ungase ukhethe ukuthatha i-hormone replacement therapy ukuze ulawule izimpawu zokunqamuka kokuya esikhathini njengokushisa.
  • Abantu abaningi abane-uterine fibroids bangakhetha ukugcina ama-ovari abo ngesikhathi salokhu kuhlinzwa.

Izingozi

Ukwelashwa kwe-uterine fibroids, kungakhathaliseki ukuthi kuyahlinzwa noma akuhlinzwa, kuza nezingozi ezingaba khona. Lezi zingozi zincike ohlotsheni lokwelashwa kanye nezici zomuntu ngamunye. Izingozi ezijwayelekile zihlanganisa:

• Ukuphuza: Ukopha kakhulu kungenzeka ngesikhathi noma ngemva kokuhlinzwa, ikakhulukazi ngezinqubo ezifana ne-myomectomy noma i-hysterectomy.
• ukutheleleka: Noma iyiphi inqubo yokuhlinzwa inengozi yokutheleleka, okungase kudinge ama-antibiotics noma ukunakekelwa okwengeziwe.
• Ukulimala kwezitho ezizungezile: Ukwelashwa okufana nokuhlinzwa noma ukuqiniswa komthambo wesibeletho kungase kuthinte ngokungenhloso izitho eziseduze, njengesinye noma amathumbu.
• Ukufaka izibazi: Izinqubo zokuhlinza, njenge-myomectomy, zingabangela ukwakheka kwezicubu ezibomvu esibelethweni noma esiswini, okungase kuthinte inzalo noma kubangele ubuhlungu.
• Izinselele zokuzala: Okunye zokwelapha kungase kuthinte ikhono lokukhulelwa, okwesikhashana noma unomphela. Isibonelo, i-hysterectomy iqeda amathuba okukhulelwa.
• Izimpawu zokunqamuka kokuya esikhathini: Uma ama-ovari ekhishwa ngesikhathi sokuhlinzwa, ukunqamuka kokuya esikhathini kusenesikhathi kungase kwenzeke, okuholela ezimpawu ezifana nokushisa okushisayo, ukushintsha kwemizwelo, nokulahlekelwa amathambo.
• Ukuphinda: Ukwelashwa okungahlinzeki, okufana nemithi noma ukufakwa komthambo wesibeletho, kungase kungawaqedi ngokuphelele ama-fibroids, futhi ama-fibroids amasha angase athuthuke ngokuhamba kwesikhathi.
• Ukungezwani komzimba noma ukusabela okubi: Abanye abantu bangase babe nemiphumela engemihle yemithi noma izinkinga ezihlobene ne-anesthesia esetshenziswa phakathi nezinqubo.

Prevention

Abukho ubufakazi obuningi besayensi obutholakalayo obusikhanyisela ngezizathu zokuthi kungani abesifazane abaseminyakeni yokuzala abantwana behlakulela i-uterine fibroids. Lokhu kwenza kube nzima kwabesifazane ukwazi ukuthi yini engase iholele ekukhuleni kwalezi zifo ezingenawo umdlavuza esibelethweni. Udokotela wakho angase abelane ngezinyathelo ezivamile ongazithatha ukuze usize ukugwema ukuthola ama-fibroids, nokho, ngobufakazi obuncane besayensi obutholakalayo, ukuvimbela kungase kungenzeki. 

Uhlangothi olukhanyayo luwukuthi lezi yizimila ezingenawo umdlavuza futhi ngokuvamile, azidingi noma yiluphi uhlobo lokwelashwa. Ingozi yokuthola ama-fibroids ingancishiswa ngokulandela indlela yokuphila enempilo, ukudla ukudla okunempilo njengemifino nezithelo, ukuvivinya umzimba njalo, kanye nokuhlolwa okuvamile kwezifo zabesifazane, okuhlanganisa izinketho ezifana ne-uterine fibroid embolization e-Hyderabad. Olunye ucwaningo luphinde lwaphakamisa ukuthi ingozi yokuthola i-uterine fibroids ingase yehle uma uthatha izinto zokuvimbela inzalo ezingamahomoni. Nokho, lesi akusona isixazululo esihlala njalo noma esisebenzayo kuwo wonke umuntu. Ngakho-ke, ukunakekela umzimba wakho kusukela usemncane nokulandela indlela yokuphila enempilo kuyindlela engcono kakhulu yokuvimbela ukuthola ama-fibroids.