Umdlavuza wesibeletho

Umdlavuza wesibeletho umdlavuza oqala emlomo wesibeletho. Umlomo wesibeletho yingxenye engezansi yesibeletho (isibeletho) evuleka ngaphezulu kwesitho sangasese sowesifazane.

Emhlabeni wonke, umdlavuza wesibeletho wuhlobo lwesithathu lomdlavuza oluvame kakhulu kwabesifazane. Akuvamile kakhulu e-United States ngenxa yokusetshenziswa okujwayelekile kwama-Pap smears.

Umdlavuza womlomo wesibeletho uqala kumaseli ebusweni bomlomo wesibeletho. Kunezinhlobo ezimbili zamaseli ebusweni bomlomo wesibeletho, squamous and columnar. Iningi lomdlavuza womlomo wesibeletho uvela kumaseli angaqinile.

Umdlavuza womlomo wesibeletho uvame ukukhula kancane. Iqala njengesimo esichazayo esibizwa nge-dysplasia. Lesi simo singatholakala ngePap smear futhi siyelapheka cishe ngo-100%. Kungathatha iminyaka ukuthi i-dysplasia ikhule ibe ngumdlavuza womlomo wesibeletho. Iningi labesifazane okutholakala ukuthi linomdlavuza womlomo wesibeletho namuhla belingenayo i-Pap smear ejwayelekile, noma bengazange balandele imiphumela engajwayelekile yePap smear.

Cishe wonke umdlavuza womlomo wesibeletho ubangelwa yi-human papillomavirus (HPV). I-HPV igciwane elijwayelekile elisakazwa ngokuxhumana kwesikhumba nesikhumba nangokobulili. Kunezinhlobo eziningi (zamagciwane) ze-HPV. Ezinye izinhlobo ziholela kumdlavuza womlomo wesibeletho. Ezinye izinhlobo zingadala izinsumpa zangasese. Ezinye azibangeli zinkinga nhlobo.

Imikhuba nezindlela zokuya ocansini zowesifazane kungakhuphula ubungozi bokuba nomdlavuza wesibeletho. Izenzo zobulili eziyingozi zifaka:

• Ukuya ocansini usemncane
• Ukuba nabalingani abaningi bezocansi
• Ukuba nomlingani noma abalingani abaningi ababamba iqhaza emisebenzini yezocansi enobungozi obukhulu

Ezinye izinto ezinobungozi zomdlavuza wesibeletho zifaka:

• Awutholi umuthi wokugoma we-HPV
• Ukuncishwa amathuba kwezomnotho
• Ukuba nomama owathatha umuthi i-diethylstilbestrol (DES) ngesikhathi ekhulelwe ekuqaleni kweminyaka yama-1960 ukuvikela ukukhulelwa kwesisu
• Ukuba namasosha omzimba abuthakathaka

Isikhathi esiningi, umdlavuza wokuqala wesibeletho awunazimpawu. Izimpawu ezingenzeka zifaka:

• Ukopha okungavamile kwesitho sangasese sowesifazane phakathi kwezikhathi, ngemuva kocansi, noma ngemuva kokunqamuka kokuya esikhathini
• Ukukhishwa kwesitho sangasese sowesifazane okungapheli, futhi kungahle kuphaphatheke, kube namanzi, kubomvana, kube nsundu, kube negazi noma kunuke kabi
• Izikhathi eziba nzima kakhulu futhi zihlala isikhathi eside kunokujwayelekile

Umdlavuza womlomo wesibeletho ungasakazekela esithweni sangasese, kuma-lymph node, esinyeni, emathunjini, emaphashini, emathanjeni nasesibindi. Imvamisa, azikho izinkinga kuze kube yilapho umdlavuza usuthuthukile futhi ususabalele. Izimpawu zomdlavuza wesibeletho osezingeni eliphakeme zingabandakanya:

• Ukuhlungu obusemhlane
• Ubuhlungu bamathambo noma ukuqhekeka
• Ukukhathala
• Ukuvuza komchamo noma indle esithweni sangasese
• Ubuhlungu bomlenze
• Ukuphelelwa isifiso sokudla
• Ubuhlungu be-pelvic
• Umlenze owodwa ovuvukile
• Ukwehla kwesisindo

Izinguquko ezandulela umdlavuza womlomo wesibeletho nomdlavuza wesibeletho azibonakali ngamehlo. Ukuhlolwa okukhethekile namathuluzi kuyadingeka ukubona lezi zimo:

• I-Pap smear ihlolela abaphambili nomdlavuza, kepha ayenzi ukuxilongwa kokugcina.
• Ngokuya ngeminyaka yakho, i-human papillomavirus (HPV) DNA test ingenziwa kanye nePap test. Noma ingasetshenziswa ngemuva kokuthi owesifazane abe nemiphumela yokuhlolwa kwePap engajwayelekile. Ingasetshenziswa futhi njengesivivinyo sokuqala. Khuluma nomhlinzeki wakho wezokunakekelwa kwempilo mayelana nokuthi yikuphi ukuhlolwa noma ukuhlolwa okulungele wena.
• Uma kutholakala izinguquko ezingajwayelekile, umlomo wesibeletho uvame ukuhlolwa ngaphansi kokukhuliswa. Le nqubo ibizwa ngokuthi i-colposcopy. Izingcezu zezicubu zingasuswa (biopsied) phakathi nale nqubo. Lesi sicubu bese sithunyelwa elebhu ukuze sihlolwe.
• Inqubo ebizwa nge-cone biopsy nayo ingenziwa. Le yinqubo esusa isigaxa esifana nesigaxa ngaphambili komlomo wesibeletho.

Uma kutholakala umdlavuza wesibeletho, umhlinzeki uzo-oda ezinye izivivinyo. Lokhu kusiza ukuthola ukuthi umdlavuza ususabalale kangakanani. Lokhu kubizwa ngokuthi isiteji. Ukuhlolwa kungafaka:

• I-x-ray yesifuba
• Ukuhlolwa kwe-CT okhalweni
• I-cystoscopy
• I-pyelogram efakwa emithanjeni (IVP)
• I-MRI yesikhumba
• Ukuskena kwe-PET

Ukwelashwa komdlavuza womlomo wesibeletho kuncike kulokhu:

• Isigaba somdlavuza
• Usayizi nokuma kwesimila
• Iminyaka yowesifazane nempilo ejwayelekile
• Isifiso sakhe sokuba nezingane esikhathini esizayo

Umdlavuza wokuqala wesibeletho ungalapheka ngokususa noma ngokucekela izicubu ezinomdlavuza noma ezinomdlavuza. Yingakho ama-Pap smear ajwayelekile abaluleke kakhulu ukuvikela umdlavuza wesibeletho, noma ukuwuthola usaqala. Kunezindlela zokuhlinza zokwenza lokhu ngaphandle kokukhipha isibeletho noma ukulimaza umlomo wesibeletho, ukuze owesifazane akwazi ukuthola izingane ngokuzayo.

Izinhlobo zokuhlinzekwa kwesikhumba somlomo wesibeletho, futhi kwesinye isikhathi, umdlavuza omncane wokuqala wesibeletho ufaka:

• Inqubo ye-Loop electrosurgical excision (LEEP) - isebenzisa ugesi ukususa izicubu ezingavamile.
• I-Cryotherapy - iqina amaseli angajwayelekile.
• Ukwelashwa nge-Laser - isebenzisa ukukhanya ukushisa izicubu ezingavamile.
• I-Hysterectomy ingadingeka kwabesifazane abane-precancer abathole izinqubo eziningi ze-LEEP.
  

Ukwelashwa komdlavuza wesibeletho osezingeni eliphakeme kungabandakanya:

• I-Radical hysterectomy, esusa isibeletho kanye nezicubu eziningi ezizungezile, kufaka phakathi ama-lymph node nengxenye ephezulu yesitho sangasese sowesifazane. Lokhu kuvame ukwenziwa kwabesifazane abasebasha, abanempilo enezicubu ezincane.
• Ukwelashwa ngemisebe, kanye ne-chemotherapy ephansi yedosi, kuvame ukusetshenziselwa abesifazane abanezicubu ezinkulu kakhulu kwi-hysterectomy enamandla noma abesifazane abangakwazi ukwelashwa kahle.
  
• Ukuqina kwepelvic, uhlobo olweqisayo lokuhlinzwa lapho kususwa khona zonke izitho zesisu, kufaka phakathi isinye kanye nengxenyeni.

Imisebe nayo ingasetshenziselwa ukwelapha umdlavuza obuyile.

I-Chemotherapy isebenzisa izidakamizwa ukubulala umdlavuza. Inganikezwa yodwa noma ngokuhlinzwa noma ngemisebe.

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Ukuthi umuntu wenza kahle kangakanani kuncike ezintweni eziningi, kufaka phakathi:

• Uhlobo lomdlavuza womlomo wesibeletho
• Isigaba somdlavuza (sisabalale kangakanani)
• Iminyaka nempilo ejwayelekile
• Uma umdlavuza ubuya emuva kokwelashwa

Izimo ezandulela umdlavuza zingelashwa ngokuphelele lapho zilandelwa futhi ziphathwe kahle. Iningi labesifazane liyaphila eminyakeni emihlanu (isilinganiso sokusinda seminyaka emihlanu) somdlavuza osusabalele ngaphakathi kwezindonga zomlomo wesibeletho kodwa hhayi ngaphandle kwendawo yomlomo wesibeletho. Izinga lokusinda leminyaka emihlanu lehla njengoba umdlavuza usakazeka ngaphandle kwezindonga zomlomo wesibeletho ungene kwezinye izindawo.

Izinkinga zingafaka:

• Ingozi yomdlavuza ebuya kubantu besifazane abanemishanguzo yokonga isibeletho
• Izinkinga zomsebenzi wobulili, wamathumbu, nowesisu ngemuva kokuhlinzwa noma imisebe

Shayela umhlinzeki wakho uma:

• Angikaze ngibe ne-Pap smear ejwayelekile
• Ukopha ngokweqile noma uketshezi olungajwayelekile esithweni sangasese

Umdlavuza wesibeletho ungagwenywa ngokwenza okulandelayo:

• Thola umuthi wokugoma we-HPV. Umuthi wokugoma uvimbela izinhlobo eziningi zokutheleleka nge-HPV ezibanga umdlavuza wesibeletho. Umhlinzeki wakho angakutshela ukuthi umuthi wokugoma ukufanele yini.
• Zijwayeze ukwenza ucansi oluphephile. Ukusebenzisa amakhondomu ngesikhathi socansi kunciphisa ubungozi be-HPV nezinye izifo ezithathelwana ngocansi (STIs).
• Nciphisa inani labalingani ocansini onabo. Gwema abalingani abasebenza ngokuziphatha okuyingozi kakhulu kwezocansi.
• Thola ama-Pap smear kaningi umhlinzeki wakho ancoma. I-Pap smear ingasiza ekutholeni izinguquko zakuqala, ezingalashwa ngaphambi kokuba ziphenduke umdlavuza wesibeletho.
• Thola ukuhlolwa kwe-HPV uma kunconywa umhlinzeki wakho. Ingasetshenziswa kanye nokuhlolwa kwePap ukuhlola umdlavuza wesibeletho kwabesifazane abaneminyaka engama-30 nangaphezulu.
• Uma ubhema, yeka. Ukubhema kwandisa amathuba akho okuthola umdlavuza wesibeletho.

Umdlavuza - umlomo wesibeletho; Umdlavuza wesibeletho - i-HPV; Umdlavuza womlomo wesibeletho - i-dysplasia

• I-Hysterectomy - isisu - ukuphuma
• Ukukhishwa kwe-Hysterectomy - laparoscopic -
• I-Hysterectomy - ukukhishwa kwesitho sangasese sowesifazane
• Imisebe ye-pelvic - ukukhishwa

• Umdlavuza wesibeletho
• I-neoplasia yomlomo wesibeletho
• I-Pap smear
• Umlomo wesibeletho
• Isigaxa esibandayo
• Umdlavuza wesibeletho
• I-Pap smears nomdlavuza wesibeletho

I-American College of Obstetricians kanye neGynecologists, Ikomidi Lezokunakekelwa Kwezempilo Kwentsha, Iqembu Lomsebenzi Wokugoma. Inombolo Yemibono Yekomidi 704, Juni 2017. www.acog.org/Resource-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Human-Papillomavirus-Vaccination. Kufinyelelwe ngoJanuwari 23, 2020.

Izikhungo Zokulawulwa Nokuvimbelwa Kwezifo iwebhusayithi. I-human papillomavirus (HPV). Amashidi weqiniso lomtholampilo kanye nokuholwa. www.cdc.gov/hpv/hcp/schedules-recommendations.html. Kubuyekezwe u-Agasti 15, 2019. Kufinyelelwe ngoJanuwari 23, 2020.

IHacker NF. I-dysplasia yomlomo wesibeletho nomdlavuza. Ku: IHacker NF, iGambone JC, iHobel CJ, ama-eds. IHacker and Moore's Essentials of Obstetrics and Gynecology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2016: isahluko 38.

USalcedo MP, Baker ES, Schmeler KM. I-neoplasia ye-Intraepithelial yomgudu ophansi wobulili (umlomo wesibeletho, isitho sangasese sowesifazane, isitho sangasese): i-etiology, ukuhlolwa, ukuxilongwa, ukuphathwa. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. I-Gynecology ephelele. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 28.

Iwebhusayithi ye-US Preventive Services Task Force. Umdlavuza wesibeletho: ukuhlolwa. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Kukhishwe ngo-Agasti 21, 2018. Kufinyelelwe ngoJanuwari 23, 2020.