Ukuba wena okanye umntu obathandayo uhlolisiswa ngumhlaza wesisu, kungabangela uxinzelelo kunye nexesha elixakekayo. Kodwa ngokufunda ngokubanzi njengoko unako malunga nalo mqathango, kubandakanywa neemvavanyo ezenzelwe ukuyixilonga, sele usethatha indima ebalulekileyo ekunyamekeleni kwakho.
Kwakhona, zama ukuhlala ulungelelanise ngokunokwenzeka, kuba nokubuza malunga nokukhetha iqela lakho lomdlavuza wesibindi, kwaye uye kwiindawo zokuqeshwa kunye neemvavanyo kunye nomlingane okanye othandekayo othandekayo.
I-Pre-Diagnosis
Ukuxilongwa komhlaza wesibeleko kuqala ngengxoxo epheleleyo kunye nogqirha wakho. Ukongezelela ukuphonononga iimpawu zakho, ugqirha wakho unokubuza imibuzo malunga nemingcipheko yesifo somhlaza wesibeletho , njengokuba utshaya ugqabi (okanye unembali yalo) okanye nokuba unayo nayiphi na imichiza kwindawo yokusebenzela.
Ugqirha wakho uya kwenza uvavanyo oluthile. Kubantu, oku kuquka ukuhlolwa kweeriteli kunye nokuhlolwa kweprotate ; kubasetyhini, uvavanyo oluqhubekayo lomzimba luqhutyelwa. Injongo yale miviwo kukubona ukuba nayiphi into engaqhelekanga inokuvakalelwa, njengesisu sekhanda.
I- urinalysis kunye neenkcubeko zamanzi ziyenziwa ukuqinisekisa ukuba iimpawu zakho azikho kwiintsholongwane, eziqhelekileyo kunomdlavuza wesibeletho. Ukungabikho kwintsholongwane kunye / okanye ukuba nayiphi na into engaqhelekanga kwimvavanyo okanye uviwo, uya kuthunyelwa kwi- urologist , ugqirha ogxininise ekuphatheni izifo zesistim se-urinary (kunye nenkqubo yokuzala inzala).
Uvavanyo lweBeb
Xa u tyelela i-urologist yakho, baya kululeka uvavanyo olusisigxina ukuze luncede ukuxilonga imeko yakho.
Urine Cytology
Nge-urtolo cytology, ugqirha ukhangela phantsi kwe-microscope kwisampula somchamo lomntu ukukhangela amangqamuzana omhlaza. Nangona i-cytology yomchamo ikulungele ukulawula umdlavuza wesibeleko, akusilo luvavanyo oluthembekileyo lokulawula umhlaza wesisu.
Yingakho asiyiyo yokuvavanya kakuhle kwaye isetyenziswe kakhulu kubantu ababenayo impawu okanye iimpawu zesifo somhlaza wesisu.
Iimpawu zeMpawu zeeUreine
Kukho inani leemvavanyo ezingakhangela ezinye iiprotheni okanye iimpawu kumchamo onokusolazela ngomhlaza wesisu. Njenge-cytology ye-urine, abamakishi be-tumor markers abanomda. Ezi mvavanyo zingaphoswa abantu abanomdlavuza wesibeleko okanye iimvavanyo zingaqhelekanga kubantu abangenayo umdlavuza, ezinokubangela ukuxhalaba kunye novavanyo oluninzi olungadingekile.
Uvavanyo lweNkqubo
Ngoku, makhe sijonge kwiinketho ezithembekileyo, kodwa zikhona ezinokungabonakaliyo.
I-Cystoscopy
Kanye neemvavanyo zomchamo, i-urologist iya kwenza i- cystoscopy , ukuhlolwa komgangatho wegolide wokufumanisa umhlaza wesibeleko. I-cystoscopy idla ngokuqhutywa kwiofisi yakho ye-urologist phantsi kwe-anesthesia yendawo. Inkqubo enobungozi obuphantsi, nangona ukuphuma kwegazi kunye nokusuleleka kungenzeka. Ngamanye amaxesha i-cystoscopy yenziwa kwigumbi lokusebenza phantsi kwe-anesthesia jikelele, oku kuthetha ukuba uya kulala.
Ngethuba le-cystoscopy, i-urologist izakubeka i-cystoscope, isixhobo esinokuguquguquka, esinjengothubhu esinekhamera elula kunye nekhamera yevidiyo, ngokusebenzisa i-urethra yakho nakwi-bladder yakho. I-urethra yakho iya kubalwa ne-gel ukuba ukhona kwiofisi yakho.
Isisombululo esinyumbayo sijongelwa kwisitya, ngoko solule kwaye sigcwaliswe. I-urologist iya kusebenzisa i-cystoscope ukujonga ngeso elingaphakathi ibhanti yakho ukuze ubone ukuba kukho i-tumor (okanye i-tumors multiple). Ukuba kukho i-tumor, bayakwazi ukubona ukuba yintoni na, yintoni ebonakala ngathi, inkulu kangakanani, kwaye ingaba zikhona naziphi izinto ezingafaniyo.
UkuSungulwa kweTransurethral ye-Bladder Tumor
Ngexesha le-cystoscopy, ukuba i-tumor okanye indawo engavumelekanga yesibindi ibonakala, i-urologist yakho iya kuthatha i- biopsy yayo. Olu hlobo lwe-biopsy lubizwa ngokuba yi-transitionthral resection ye-tumor bladder, okanye i-TURBT, kwaye ibandakanya ugqirha ukususa i-tumor yebladder kunye nenxalenye yodonga lwe-muscular kufuphi ne-tumor.
Ukuba akukho buhlungu bubonwa kodwa ugqirha usasaxhala ngomdlavuza (i-cytology yomchamo inokuthi ibe ne-positive), inokuthatha i-biopsies ezininzi. Baya kujonga nokuthatha ii-biopsies zezinye iindawo zendlela yokucoca, njengentsimbi kunye neprotate (ukuba yindoda).
Emva koko, ugqirha obizwa ngokuba ngu- pathologist unokukhangela i-biopsy phantsi kwe-microscope kwaye ubone ukuba kukho iiseli zomhlaza. Oku kunikeza ubungqina bomdlavuza wesifo somhlaza. Kwaye, xa umhlaza wesisu usuqinisekisiwe, ibakala lomhlaza linokumiselwa. Kukho amabini omhlaza wesifo somhlaza:
- Umhlaza womhlaza wesibhanki ophantsi: Iiseli zomhlaza zifana neeseli zesifo somhlaza wesisu.
- Umhlaza wesibeletho se-bladder: Amaseli omhlaza awabonakali njengamaqhekeza omhlaza wesibeleko.
Ngokubanzi, iidanga ze-bladder ze-bladder ziphezulu zibhekwa njengento enobudlova kwaye ngoko kunzima ukuphatha unyango ongaphantsi kwamabhanki.
Uvavanyo lweemvavanyo
Ukuhlola iimvavanyo kuyafuneka ukuba uhlolisise umhlaza wesifo somhlaza.
CT okanye iMRI Scans
I-urrogram ye-CT yindlela yokuhlola i-imaging esetyenziselwa ukuvavanya iinjongo, i-ureters, ne-vestile. Ingakunika ulwazi oluxabisekileyo malunga nesisu sesisu, njengobungakanani bayo, imilo, kunye nendawo kunye nokuba umhlaza usasaze ngaphandle kwesikhumba.
I-urrogram ye-MRI ingaba luncedo, inika ulwazi olongezelelweyo kwi-CT scan. Isetyenziswe nakwabantu abahlukumeza idayi, esetyenziswa kwi- CT scan , kodwa ingekho iMRI.
Ezinye iimvavanyo zokujonga
Ngamanye amaxesha ezinye iimvavanyo zengcamango ziyalwe, ngokukodwa ukuba i-CT okanye iMRI i-scans ayifumaneki.
- I-pyelogram ye-intravenous, okanye i-IVP, yinkqubo apho idayi ifakwe kwisisu somntu kwaye i-x-ray yenkqubo ye-urinary iphetshana ithathwa. (Iinjongo kunye ne-ultrasound ye-bladder ayifuni idayi eyahlukileyo okanye i-radiation, njengoko isebenzisa amaza omsindo ukubonelela imifanekiso.)
- I-x-ray isifuba senziwa ukuze kuqinisekiswe ukuba umhlaza usasazeke kwimiphunga.
- I- scan scan ingahlawuliswa ukuba umntu onomdlavuza wesisu usentlungu.
Ukucwangcisa
Ukongeza kwinqanaba le-tumor yakho, ugqirha wakho uya kugqiba isigaba sayo, esithetha ukuba umhlaza usasazeke kangakanani. Ngokubanzi, isiteji kunye nebakala le-tumor yakho lidlala indima enkulu kwindlela umhlaza wakho wesifo uphathwa ngayo kunye nethuba lokubuyisela.
Isitetimenti seklinikhi yomhlaza wesantya somntu ngokuqhelekileyo unqunywe kwizinto ezintathu:
- Iziphumo ze-biopsy / TURBT
- Uvavanyo olubonakalayo olwenziwa ngugqirha ngelixa liphantsi kwe-anesthesia (xa i-TURBT yenziwa)
- Izifundo zokucinga
Isigaba sesi-0 sisona sigaba sokuqala somhlaza wesisu kunye nomqondiso wesifo somhlaza awuzange usasaze kwi-lining yangaphakathi yesilwanyana. Isigaba IV yisona sigaba esona siphezulu kakhulu kwaye sichaza ukuba umhlaza usasazeke kwi-pelvis, isisu, i-lymph nodes eseduze, kunye / okanye kwiindawo ezikude emzimbeni.
Udokotela wesifo somhlaza wesibindi uya kusebenzisa iileta ezintathu (kunye neenombolo emva koonobumba) ukuchaza ngokubanzi isigaba somntu:
- I-T for Tumor: Lo mbhalo uchaza ukuba i-tumor ye-bladder ikhule kangakanani. Umzekelo, nokuba uye wakhula waba ngodonga lwe-muscular ye-bladder okanye ayikho.
- I-N yeeNode: Lo mbhalo uchaza ukuba umhlaza usasazeke kunoma yiyiphi i-lymph nodes eseduze.
- M for Metastasis : Lo mbhalo uchaza ukuba umhlaza usasazeke kwezinye iindawo zomzimba, njengobindi, amathambo, okanye imiphunga.
Ukuphakama kwamanani emva kwale leta, ekude nomhlaza kwaye kunzima kakhulu ukunyanga.
> Imithombo:
> I-American Cancer Society. Uvavanyo lweCancer Cancer. Meyi 2016.
> Chang et al. Ukuxilongwa kunye nokunyangwa komhlaza ongenawo umzimba ongenawo umzimba: Umkhokelo we-AUA / SUO. J Urol. 2016 Oct; 196 (4): 1021-9.
> Chou R et al. Iimpawu ze-Urinary ze-urine zokuxilongwa komhlaza wesisu: Ukuhlolwa ngokuchanekileyo kunye nokuhlaziywa kwemeta. Ann Intern Med . Ngomhla ka-15, Dec 15; 163 (12): 922-31.
> Lotan Y, Choueiri TK. Imfundo yesineke: Ukuxilongwa komhlaza wesifo kunye nesiteji (ngaphaya kweZiseko). Ku: U-UpToDate, uLerner SP (Ed), UpToDate, Waltham, MA.
> Amandla NE, i-Izawa J. Ukuthelekiswa kwezikhokelo zomhlaza wesibeleko esingenayo isisu (EAU, CUA, AUA, NCCN, NICE). Bl Cancer. 2016; 2 (1): 27-36.