Uma wena noma othandekayo uhlolwe umdlavuza wesisu, kungaba yisikhathi esicindezelayo nesinzima kakhulu. Kodwa ngokufunda okuningi ngangokunokwenzeka mayelana nesimo, kufaka phakathi izivivinyo ezenzelwe ukuyihlolisisa, usuvele uthatha indima esebenzayo ekunakekeleni kwakho.
Futhi, zama ukuhlala uhlelekile ngangokunokwenzeka, yiba nokubuza mayelana nokukhetha ithimba lomdlavuza wesisu sakho, futhi uhambele ukuqokwa kanye nokuhlolwa nomlingani noma othandekayo othandekayo.
I-Pre-Diagnosis
Ukuxilongwa komdlavuza wesibeletho kuqala ngokuxoxa kahle nodokotela wakho. Ngaphandle kokubukeza izimpawu zakho, udokotela wakho angakubuza imibuzo mayelana nomdlavuza wesifo somdlavuza wesibindi , njengokungathi uyabhema yini ugwayi (noma unomlando) noma ngabe unomshini wokushiswa kwamakhemikhali emsebenzini.
Udokotela wakho uzophinde ahlole. Kubantu, lokhu kuhlanganisa ukuhlolwa kwe-rectal kanye nokuhlolwa kwesicathulo ; kwabesifazane, ukuhlolwa kwe- recto-vaginal kuqhutshwa. Inhloso yalezi zivivinyo ukubona ukuthi noma yini engavamile ingazizwa, njenge-tumor yesisu.
I- urinalysis kanye namasiko omchamo nawo kwenziwa ukuqinisekisa ukuthi izimpawu zakho aziveli ekutheleleni, okuvame kakhulu kunomdlavuza wesibeletho. Uma kungekho ukutheleleka kanye / noma uma kukhona okungavamile ukuhlolwa kwakho noma ukuhlolwa kwakho, uzothunyelwa kudokotela we- urologist , udokotela ogxile ekwelapheni izifo zesimiso se-urinary (kanye nesistimu yokuzala owesilisa).
Izivivinyo ze-Lab
Uma uvakashela i-urologist yakho, bazokhipha ukuhlolwa okunamandla ukusiza ukuxilonga isimo sakho.
I-Urine Cytology
Nge-urtolo cytology, udokotela ubukeka ngaphansi kwe-microscope kumsampula womchamo womuntu ukuze afune amaseli omdlavuza. Ngesikhathi i-urtolo cytology inhle ekubhekaneni nomdlavuza wesisu, akuyona ukuhlolwa okuthembekile kokulawula umdlavuza wesisu.
Yingakho kungesivivinyo esihle sokuhlola futhi sisetshenziswe kakhulu kubantu abanesibonakaliso noma izimpawu zesifo somdlavuza wesisu.
Ama-Marker Tumor Tumor
Kukhona izivivinyo eziningi ezingabheka amaprotheni noma izimpawu emcinini osolisayo ngomdlavuza wesibeletho. Njenge-cytology yomchamo, izimpawu ze-tumor zomchamo zinomkhawulo wazo. Lezi zivivinyo zingaphuthelwa abantu abanomdlavuza wesibeletho noma ukuhlolwa kungase kungavamile kubantu abangenawo umdlavuza, okungaholela ekukhathazeni nasekuhlolweni okungadingekile.
Izivivinyo zezinqubo
Manje, ake sibheke okukhethwa kukho okunamandla, okwamanje okunamandla, okungajwayelekile.
I-Cystoscopy
Kanye nezivivinyo zomchamo, i-urologist izokwenza i- cystoscopy , ukuhlola okujwayelekile kwegolide ukuze kutholakale umdlavuza wesibeletho. I-cystoscopy ivame ukusebenza ehhovisi lakho le-urologist ngaphansi kwe-anesthesia yendawo. Kuyindlela encane yokufaka ingozi, nakuba ukuphuma kwegazi nokutheleleka kungenzeka. Ngezinye izikhathi i-cystoscopy yenziwa ekamelweni lokusebenza ngaphansi kwe-anesthesia ejwayelekile, okusho ukuthi uzolala.
Ngesikhathi i-cystoscopy, i-urologist izobeka i-cystoscope, ithuluzi eliguquguqukayo, elifana ne-tube-tube elinomshini omncane nevidiyo encane, ngokusebenzisa i-urethra yakho nasesikhathini sakho. I-urethra yakho izokalwa ne-gel uma ukhona ehhovisi likadokotela wakho.
Isixazululo esiyinyumba sishaywa igciwane, ngakho-ke sinwetshiwe futhi sigcwele. Urologist uzobe esebenzisa i-cystoscope ukubona ngeso lengqondo ukufaka ngaphakathi kwesikhumba sakho ukuze ubone ukuthi kukhona isisu (noma izicubu eziningi) ezikhona. Uma kune-tumor, bangabona ukuthi liphi ngempela, ukuthi libukeka kanjani, likhulu kangakanani, nokuthi ngabe likhona yini okungavamile kwe-mucosal.
Ukutholakala kweTransurethral yeSondon Tumor
Ngesikhathi i-cystoscopy, uma isisu noma indawo engavamile yesikhumba ibonakala, isazi sakho se-urologist siyothatha i- biopsy yayo. Loluhlobo lwe-biopsy lubizwa ngokuthi ukuthengiswa kwe-transurethral yesisu sesisu, noma i-TURBT, futhi kufaka udokotela esusa isisu sesisu kanye nengxenye yodonga lwe-muscular eduze kwe-tumor.
Uma kungabonakali isisu kodwa udokotela usazokhathazeka ngomdlavuza (i-urine cytology ingahle ihleleke), bangathatha ama-biopsies amaningi okungahleliwe. Bazocabangela nokuthatha ama-biopsies kwezinye izingxenye zesistimu ye-urinary tract, njenge-urethra ne-prostate (uma isilisa).
Khona-ke, udokotela obizwa ngokuthi i- pathologist angabheka i-biopsy ngaphansi kwe-microscope futhi abone ukuthi imilayezo yamangqamuzana ikhona yini. Lokhu kunikeza isiqinisekiso sesifo somdlavuza wesisu. Futhi, uma umdlavuza wesisu usuqinisekisiwe, ibanga lomdlavuza linganqunywa. Kunezigaba ezimbili zomdlavuza wesibeletho:
- Umdlavuza wesisu omncane ophansi: Lezi zingqamuzana zomdlavuza zifana namangqamuzana omdlavuza wesibeletho.
- Umdlavuza wesibhado ophakeme kakhulu: Lezi zingqamuzana zomdlavuza azibuki njengezijwayelekile zomdlavuza wesisu.
Ngokuvamile, i-high-grade yegciwane lesandulela ngculazi ibhekwa njengento enobudlova futhi ngakho-ke kunzima ukuphatha ukwedlula ukwelashwa okuphansi kwesibhado.
Ukuhlolwa kwezilingo
Ukuhlola ukuhlolwa kuyadingeka ukuze kuhlolwe isifo somdlavuza wesisu.
CT noma iMRI Scans
I-urogram ye-TC isilingo sokuhlola izithombe esetshenziselwa ukuhlola izinso, ureters, kanye nesinye. Ingahlinzeka ngolwazi olubalulekile mayelana nesisu sesisu, njengobungakanani bayo, ukuma, nendawo kanye nokuthi umdlavuza usakaze ngaphandle kwesinye.
I-urogram ye-MRI ingase ibe usizo, inikeza ulwazi oluthe xaxa kusuka ku-CT scan. Ibuye isetshenziswe kubantu abahlukunyezwayo ukuze bahluke idayi, esetshenziswe ku- CT scan , kodwa hhayi i-MRI.
Ezinye izivivinyo zokufanisa
Ngezinye izikhathi ezinye izivivinyo ze-imaging ziyalwe, ikakhulukazi uma ukuhlolwa kwe-CT noma i-MRI kungatholakali.
- I-pyelogram e-intravenous, noma i-IVP, yinkqubo lapho idayi igonywa khona emthanjeni womuntu bese kuthiwa i-x ray ye-system tract system. (I-aphi ne-vestide ultrasound ayidingi idayisi yokuhlukanisa noma imisebe, njengoba isebenzisa amagagasi omsindo ukunikeza izithombe.)
- I-x-ray isifuba senziwa ukuze kunqume ukuthi umdlavuza usakaze yini emaphashini.
- Ukukhishwa kwethambo kungalawulwa uma umuntu onomdlavuza wesinye isifo sofuba.
Isiteji
Ngaphandle kwebanga le-tumor yakho, udokotela wakho uzophinde anqume isiteji saso, okusho ukuthi umdlavuza usakaze kangakanani. Ngokuvamile, isiteji nesigaba se-tumor yakho sidlala indima enkulu endleleni umdlavuza wakho wesisu ophathwa ngayo kanye nokuthola ithuba lokuthola kabusha.
Isigaba somtholampilo somdlavuza womuntu wesinye isikhathi sinqunywa kusuka ezintweni ezintathu:
- Imiphumela ye-biopsy / TURBT
- Ukuhlolwa ngokomzimba okwenziwa udokotela ngenkathi ngaphansi kwe-anesthesia (uma i-TURBT isenziwa)
- Ucwaningo lokucwaninga
Isiteji sesi-0 yisigaba sokuqala somdlavuza wesisu futhi kusho ukuthi umdlavuza awusakazeki ngaphakathi kwesikhumba sangaphakathi. Isigaba IV yisigaba esiphezulu kunazo zonke futhi kusho ukuthi umdlavuza usakaze ku-pelvis, isisu, izitho zamakhemikhali eziseduze, kanye / noma izindawo ezikude emzimbeni.
Udokotela womdlavuza wesisu uzosebenzisa izinhlamvu ezintathu (kanye nezinombolo emva kwezinhlamvu) ukuqhubeka nokuchaza isigaba somuntu:
- I-T for Tumor: Lesi sici sichaza ukuthi kude kangakanani isisu sesisu sakhulile. Isibonelo, kungakhathaliseki ukuthi sekukhulile waba ngodonga lwe-muscular of the vessie noma cha.
- I-N for Nodes: Lesi sici sichaza ukuthi umdlavuza usakaze kunoma yiziphi izitho zamakhansela eziseduze.
- M for Metastasis : Lesi sici sichaza ukuthi umdlavuza usakaze kwezinye izingxenye zomzimba, njengobindi, amathambo namaphaphu.
Ukuphakama kwezinombolo emva kwalezi zincwadi, ngaphezu komdlavuza kunzima futhi ukwelapha kakhulu.
> Imithombo:
> I-American Cancer Society. Uvivinyo lweKhansela Yesikhumba. May 2016.
> Chang et al. Ukuxilongwa nokwelashwa komdlavuza wesibeletho esingenayo imisipha: Isiqondiso se-AUA / SUO. J Urol. 2016 Okthoba; 196 (4): 1021-9.
> Chou R et al. Ama-biomarker e-Urinary ukuze ahlolwe umdlavuza wesisu: Ukubuyekezwa okuhlelekile nokuhlaziywa kwe-meta. U-Ann Intern Med . 2015 Dec 15; 163 (12): 922-31.
> Lotan Y, Choueiri TK. Imfundo yesineke: Umdlavuza wesifo sofuba kanye nesiteji (Beyond the Basics). Ku: UpToDate, uLerner SP (Ed), UpToDate, Waltham, MA.
> Amandla NE, i-Izawa J. Ukuqhathaniswa kwemihlahlandlela yomdlavuza wesibeletho ongenayo imisipha (EAU, CUA, AUA, NCCN, NICE). Bl Cancer. 2016; 2 (1): 27-36.