I-Benign and pathology evame kakhulu, i-prostate adenoma ihlasela ingxenye yesine yamadoda aphakathi kweminyaka engama-55 nengama-60 ubudala futhi ngaphezu kwendoda eyodwa kwamabili aphakathi kweminyaka engama-66 nengama-70 ubudala. Yiziphi izimpawu ? Indlela yokuyixilonga nokuyiphatha? Izimpendulo zika-Inès Dominique, udokotela womchamo

Ebizwa nangokuthi i-benign prostatic hyperplasia (BPH), i-prostate adenoma iwukwanda kancane kancane kobukhulu bendlala yesinye. “Lokhu kukhuphuka kwevolumu kubangelwa ukwanda kwamangqamuzana e-prostate ahlobene nokuguga” kusho uDkt Dominique.

Imvamisa yale pathology ikhula ngokukhula futhi ithinta cishe amaphesenti angama-90 amadoda angaphezu kwama-80 kuya kumazinga ahlukahlukene. "Kuyisifo esingelapheki, esivela eminyakeni eminingi, kodwa esingaxhumene nomdlavuza wendlala yesinye" wengeza udokotela womchamo.  

Indlela yokuthuthukiswa kwe-prostate adenoma ayiqondwa kahle.

"Kuthuthukiswe imibono eminingana: izindlela zamahomoni - ikakhulukazi nge-DHT - zingabandakanyeka, noma ukungalingani phakathi kokukhula nokubhujiswa kwamangqamuzana e-prostate" kukhombisa u-Inès Dominique.

Nokho, i-metabolic syndrome ingaba ingozi yangempela, njengoba amathuba okwelashwa kwe-prostate adenoma aphindwe kabili ezigulini ezine-metabolic syndrome.

Kwesinye isikhathi i-prostate adenoma ayibonakali nhlobo futhi itholakale ngengozi ngesikhathi sokuhlolwa kwesithombe sezokwelapha. Kodwa ngokuvamile, kubangela izimpawu zomchamo ezibangelwa ukucindezelwa kwe-urethra yi-prostate eyakhiwe ngendlela engavamile.

“Izimpawu ze-LUTS (i-urinary tract disorders) zingazwakala esigulini” kuchaza ngokukhethekile udokotela womchamo.

I-International Continence Society (ICS) ihlukanisa lezi zimpawu ngezigaba ezintathu:

Ukuphazamiseka kwesigaba sokugcwalisa 

“Lena i-pollakiuria, okuyisidingo sokuyochama njalo, okungaba imini noma ebusuku kanye nezimo eziphuthumayo zokuchama” kuchaza uDkt Dominique.

Ukuphazamiseka kwesigaba sokuthulula

"Kuyisidingo sokuphusha ukuchama, okubizwa ngokuthi i-dysuria, ubunzima bokuqalisa ukuchama noma ukugeleza komchamo obuthakathaka kanye / noma obuthakathaka" kuqhubeka uchwepheshe.

Izinkinga zesigaba se-post-voiding

"Lawa amaconsi aphuzile noma umbono wokungaqedi ngokuphelele esinyeni."

Kuyenzeka futhi ukuthi i-prostate adenoma ibangela ukungasebenzi kahle kocansi, okuhlanganisa nejethi yokuphuma ebuthaka. 

Ukuxilongwa kwe-prostate adenoma kusekelwe ekubuzeni isiguli ngezimpawu ezingase zibe khona zomchamo, ukuhlolwa ngokomzimba ngokuhlolwa kwe-digital rectal futhi ngezinye izikhathi, uma kunesidingo, imaging kanye ne-biology.

“Ukuhlolwa kwe-digital rectal kusetshenziselwa ukuhlola ubukhulu kanye nokuvumelana kwe-prostate ukuze kuqinisekiswe nokuthi awukho umdlavuza wendlala yesinye. Lokhu ukuhlola okungenabuhlungu futhi okungenabungozi ” kuchaza uDkt Dominique.

Uma kwenzeka ukungabaza, isilinganiso sokugeleza singenziwa: isiguli kufanele sichame endlini yangasese "ekhethekile" evumela ukuthi ukugeleza komchamo kuhlolwe.

Ukuthwebula kusekelwe ku-reno-vesico-prostatic ultrasound. "Kwenza kube nokwenzeka ukuhlola umthamo we-prostate, ukuqinisekisa ukungabikho kwe-calculus yesinye noma ukungahambi kahle kwesinye kanye nokuqinisekisa ukungabikho kwemiphumela yezinso" kuchaza uchwepheshe. Le ultrasound iphinde yenza kube nokwenzeka ukuhlola ukuthululwa okufanele kwesinye ngesikhathi sokuchama.

Okokugcina, i-biology isekelwe ekunqumeni kwe-hormone ye-prostate ebizwa ngokuthi i-PSA - ukuze kukhishwe umdlavuza wendlala yesinye - kanye nokuhlolwa kokusebenza kwezinso ngokuhlaziywa kwe-creatinine.

I-prostate adenoma ingase ibe nempilo, kufanele iqashwe futhi iphathwe ukuze kuvinjelwe izinkinga ezingase zibe khona.

I-Benign prostatic hyperplasia ingadala ukuvaleka kwesinye isinye kuvimbele ukuphuma kwaso ngendlela efanele, yona ngokwayo eyimbangela yezinhlobo eziningana zezinkinga: I-urinary tract infection (prostatitis), i-hematuria (ukopha emchameni) i-calculus yesinye, ukugcina umchamo oshubile noma ukwehluleka kwezinso” kuchaza uDkt Inès Dominique.

Uma nje isiguli singazizwa singakhululekile futhi singabonisi izinkinga, ukuqaliswa kokwelashwa akudingekile.

“Ngakolunye uhlangothi, uma isiguli siphazamiseka ezingeni lokuchama, ukwelashwa kwezidakamizwa okunezimpawu kuba khona ngendlela esebenza kahle kakhulu” kugcizelela udokotela womchamo.

Njengokwelashwa komugqa wokuqala, futhi lapho kungabikho ukungqubuzana, udokotela unikeza ama-alpha-blockers (Alfuzosine®, Silodosine® njll.) ukuze athuthukise izimpawu. Uma zingasebenzi ngokwanele, bese siphakamisa i-5-alpha-reductase inhibitors (Finasteride®, dutasteride®) esebenza ngokunciphisa usayizi we-prostate ngokuhamba kwesikhathi.

“Uma ukwelapha ngezidakamizwa kungasebenzi noma isiguli sinezinkinga ezivela ku-BPH, ukwelashwa kungase kuhlinzekwe. Khona-ke ukungenelela kusekelwe ekususweni kwe-urethra ". icacisa uchwepheshe

Lokhu kungenelela kungenziwa nge-urethra nge-endoscopy ngamasu ahlukene: "Ngokukhipha ugesi okuvamile noma nge-laser noma nge-bipolar enucleation" kuchaza uDkt Dominique.

Uma umthamo we-prostate mkhulu kakhulu, kungase kuphakanyiswe ukuhlinzwa okuvulekile, "Sikhuluma nge-high-way adenomectomy" icacisa uchwepheshe.

Kuze kube manje, asikho isilinganiso sokuvimbela esibonakale sisebenza kahle ekuthuthukisweni kwe-BPH.

“Okubaluleke kakhulu ukuvikela izinkinga eziqhamuka kwiBPH ezingaba yingozi kwesinye isikhathi zingapheli njengesifo sezinso esingalapheki. Ngakho-ke kubalulekile ukuthi uqaphe ngokucophelela iziguli ezine-BPH ngisho noma zingenazo izimpawu ukuze kubonakale ukuthi isinye asiphumi kahle ” kuchaza udokotela womchamo.

Imithetho yenhlanzeko okufanele ilandelwe

Ngaphezu kwalokho, imithetho yenhlanzeko yokuphila ingahlonishwa ukuze kulindelwe izinkinga ezingenzeka. Ikakhulukazi, iziguli ziyanconywa:

• Ukunciphisa ukusetshenziswa koketshezi kusihlwa: amasobho, ama-herbal teas, amanzi, iziphuzo
• Ukunciphisa ukudla okune-caffeine noma utshwala ngangokunokwenzeka,
• Ukulwa nokuqunjelwa, ngokudla okucebile izithelo, imifino, okusanhlamvu okuphelele kanye nemifino,
• Ukuzijwayeza ukuvivinya umzimba njalo.