Umdlavuza we-Vulvar
Umdlavuza we-Vulvar
Umdlavuza we-Vulvar wuhlobo lomdlavuza ohlasela ingaphandle lesitho sowesifazane. I-vulva, ehlanganisa i-clitoris kanye ne-labia, isiqephu sesikhumba esizungeze umgudu womchamo kanye nesitho sangasese sowesifazane.
Umdlavuza we-vulvar ngokuvamile uvela njengesigaxa noma isilonda ku-vulva, okubangela ukucasuka. Umdlavuza we-Vulvar uvame ukutholakala kubantu asebekhulile, kuyilapho ungenzeka kunoma iyiphi iminyaka.
Umdlavuza we-Vulvar ngokuvamile welashwa ngokuhlinzwa ukuze kukhishwe isimila kanye nenani elincane lezicubu ezinempilo ezizungezile. Ukuhlinzwa komdlavuza we-Vulvar kungase kudinge ukususwa kwe-vulva yonke. Umdlavuza we-vulvar wangaphambili utholakele, mancane amathuba okuthi uzodinga ukuhlinzwa okubalulekile ukuze welashwe. Kafushane:
- Umdlavuza we-Vulvar yisifo esingavamile lapho amangqamuzana abulalayo (umdlavuza) akheka khona ezicutshini ze-vulva.
- Ukuba ne-vulvar intraepithelial neoplasia noma ukutheleleka nge-HPV kungandisa ingozi yomdlavuza we-vulvar.
- Izimpawu zomdlavuza we-vulvar zihlanganisa ukopha noma ukulunywa endaweni ye-vulvar.
- Izivivinyo ezihlola i-vulva zisetshenziselwa ukuxilonga umdlavuza we-vulvar.
- Izici ezithile zithinta i-prognosis (ithuba lokululama) nezinketho zokwelashwa.
Umdlavuza we-Vulvar kwakheka esithweni sangasese sowesifazane. I-vulva ihlanganisa:
- Izindebe zangaphakathi nezingaphandle zesitho sangasese sowesifazane.
- I-Clitoris (izicubu ezizwelayo phakathi kwezindebe).
- Ukuvuleka kwesitho sangasese sowesifazane nezindlala zayo.
- I-Mons pubis (indawo eyindilinga ephambi kwamathambo e-pubic embozwa uboya ekuthombeni).
- I-Perineum (indawo ephakathi kwe-vulva ne-anus).
Izindebe zangaphandle zangasese yizo ezivame ukuthinteka kakhulu umdlavuza we-vulvar. Umdlavuza wezindebe zangaphakathi ze-vaginal, i-clitoris, noma izindlala zesitho sangasese sowesifazane uvela kancane.
Umdlavuza we-Vulvar uvame ukukhula ngokuhamba kwesikhathi eside. Isikhathi eside, amaseli angavamile angase ande ebusweni besikhumba se-vulvar. I-Vulvar intraepithelial neoplasia igama lezokwelapha lalesi sifo (VIN). Ngenxa yokuthi i-VIN ingathuthukela kumdlavuza we-vulvar, kubalulekile ukuthola ukwelashwa.
Izimpawu kanye nezimpawu zomdlavuza we-vulvar
Izimpawu zincike ekutheni umdlavuza noma umdlavuza wangaphambi kwesikhathi nokuthi hlobo luni lomdlavuza we-vulvar.
I-Vulvar intraepithelial neoplasia
Iningi labesifazane abane-vulvar intraepithelial neoplasia (VIN) abanazo izimpawu. Uma owesifazane one-VIN eba nezimpawu, kuvame ukuba ukulunywa okungapheli okungathuthuki. I-VIN ingaba nokubukeka okuhlukile kunesikhumba esivamile se-vulvar. Ivamise ukujiya futhi ilula kunesikhumba esizungezile. I-VIN, nokho, ingabukeka ibomvu, iphinki, noma imnyama kunesikhumba esizungezile.
Abanye besifazane abazi ukuthi bangase babe nenkinga eyingozi ngoba lezi zinguquko zivame ukubangelwa ezinye izifo ezingezona umdlavuza. Abanye abantu bazama ukuxazulula inkinga besebenzisa imishanguzo ethengwayo. Ngezinye izikhathi, odokotela bangase bangasiboni nhlobo lesi sifo.
Umdlavuza we-squamous cell ohlaselayo we-vulva
Cishe bonke abesifazane abanomdlavuza we-vulvar ohlaselayo bazoba nezimpawu. Lokhu kungafaka:
- Indawo ku-vulva ebukeka ihlukile kwejwayelekile - ingaba lula noma ibe mnyama kunesikhumba esivamile esizungezile, noma ibukeke ibomvu noma ibomvana.
- Iqhubu noma isigaxa, esingaba bomvu, esiphinki, noma sibe mhlophe futhi sibe nensumpa noma indawo eluhlaza noma sizizwe simangele noma siwugqinsi.
- Ukuqina kwesikhumba se-vulva
- Itching
- Ubuhlungu noma ukushisa
- Ukopha noma ukuphuma okungahlobene nesikhathi esivamile sokuya esikhathini
- Isilonda esivulekile (ikakhulukazi uma sihlala inyanga noma ngaphezulu)
I-Verrucous carcinoma, uhlobo oluncane lomdlavuza we-squamous cell vulvar ohlaselayo, lubukeka njengezimila ezifana ne-cauliflower ezifana nezinsumpa zesitho sangasese.
Lezi zimpawu zivame ukubangelwa ezinye izimo ezingezona umdlavuza. Noma kunjalo, uma unalezi zimpawu, kufanele uzenze zihlolwe udokotela noma umhlengikazi.
I-Vulvar melanoma
Iziguli ezine-vulvar melanoma ingaba nezimpawu eziningi ezifanayo nezinye izinhlobo zomdlavuza we-vulvar, njenge:
- Isigaxa
- Itching
- Ubuhlungu
- Ukopha noma ukuphuma
Iningi lama-vulvar melanoma amnyama noma ansundu ngokumnyama, kodwa angaba mhlophe, pink, obomvu, noma eminye imibala. Angatholakala kulo lonke i-vulva, kodwa iningi lisendaweni ezungeze i-clitoris noma ku-labia majora noma i-minora.
I-Vulvar melanomas ngezinye izikhathi ingase iqale kumvukuzane, ngakho-ke ushintsho kumvukuzane osekuyiminyaka lukhona lungabonisa ne-melanoma. I A B C D E Umthetho ungasetshenziswa ukusiza ukutshela imvukuzane evamile kwenye okungenzeka kube yi-melanoma.
I-Asymmetry: Ingxenye eyodwa yemvukuzane ayifani nenye.
Ukungahambi kahle komngcele: Imiphetho yemvukuzane inamadlakadlaka noma ayinqatshiwe.
Umbala: Umbala phezu kwemvukuzane awufani. Kungase kube nama-shades ahlukene oku-tan, ansundu, noma amnyama futhi ngezinye izikhathi amabala abomvu, aluhlaza okwesibhakabhaka, noma amhlophe.
ububanzi: Imvukuzane ibanzi kuno-6 mm (cishe 1/4 intshi).
Ukuvela: Imvukuzane iyashintsha ngosayizi, umumo, noma umbala.
Uphawu olubaluleke kakhulu lwe-melanoma ukushintsha kosayizi, ukuma, noma umbala wemvukuzane. Noma kunjalo, akuwona wonke ama-melanoma ahambisana nomthetho we-ABCDE.
Uma unemvukuzane eshintshile, cela udokotela wakho ukuthi ayihlole.
Umdlavuza we-Bartholin gland
Isisindo esihlukile (isigaxa) nhlangothi zombili zokuvuleka esithweni sangasese sowesifazane kungaba uphawu lwe-Bartholin gland carcinoma. Nokho, imvamisa, isigaxa kule ndawo sisuka ku-cyst yendlala ye-Bartholin, evame kakhulu (futhi engewona umdlavuza).
Isifo se-Paget
Ubuhlungu kanye nendawo ebomvu, enescaly izimpawu ze-Paget isifo se-vulva.
Ukuxilongwa komdlavuza we-vulvar
Umdlavuza we-Vulvar ngokuvamile awubangeli izimpawu noma izimpawu zokuqala. Izimpawu nezimpawu zingabangelwa umdlavuza we-vulvar noma ezinye izimo. Hlola nodokotela wakho uma unokunye kwalokhu okulandelayo:
- Isigaxa noma ukukhula esithweni sangasese esifana nensumpa noma isilonda.
- Ukuluma endaweni ye-vulvar engasuki.
- Ukopha okungahlobene nokuya esikhathini (izikhathi).
- Ubuhlungu endaweni ye-vulvar.
Ukuhlolwa okuhilelekile kumdlavuza we-vulvar
Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:
- Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuze kubhekwe izimpawu ezivamile zempilo, okuhlanganisa nokuhlola i-vulva ngezimpawu zesifo, njengezigaxa nanoma yini enye ebonakala ingajwayelekile. Kuzothathwa umlando wemikhuba yempilo yesiguli kanye nezifo ezidlule kanye nokwelashwa.
- Ukuhlolwa kwepelvic: Ukuhlolwa kwesitho sangasese sowesifazane, isibeletho, isibeletho, amashubhu e-fallopian, ama-ovari, kanye ne-rectum. I-speculum ifakwa esithweni sangasese bese udokotela noma umhlengikazi ebheka isitho sangasese sowesifazane nomlomo wesibeletho ukuze abone izimpawu zesifo. Ukuhlolwa kwe-Pap yomlomo wesibeletho kuvame ukwenziwa. Udokotela noma umhlengikazi aphinde afake umunwe owodwa noma emibili egcotshiwe, oyigilavu wesandla esisodwa esithweni sangasese bese ebeka esinye isandla phezu kwesisu esingezansi ukuze ezwe ubukhulu, ukuma, nokuma kwesibeletho namaqanda. Udokotela noma umhlengikazi uphinde afake umunwe ogcotshiwe, ofakwe igilavu ku-rectum ukuzwa izigaxa noma izindawo ezingavamile.
- Ukuhlolwa kwe-Pap: Inqubo yokuqoqa amaseli ebusweni bomlomo wesibeletho nesitho sangasese sowesifazane. Ucezu lukakotini, ibhulashi, noma induku encane yokhuni isetshenziselwa ukukhuhla amaseli emlonyeni wesibeletho nasesithweni sangasese. Amaseli abukwa ngesibonakhulu ukuze kutholwe ukuthi awajwayelekile yini.
- Ukuhlolwa kwe-Human Papillomavirus (HPV).: Ukuhlolwa kwaselabhorethri okusetshenziselwa ukuhlola i-DNA noma i-RNA ngezinhlobo ezithile zokutheleleka nge-HPV. Amaseli aqoqwa ku-vulva futhi i-DNA noma i-RNA evela kumaseli iyahlolwa ukuze kutholakale ukuthi ukutheleleka kubangelwa uhlobo lwe-human papillomavirus exhunywe umdlavuza we-vulvar. Lokhu kuhlolwa kungenziwa kusetshenziswa isampula yamaseli akhishwe phakathi nokuhlolwa kwe-Pap. Lokhu kuhlolwa kungenziwa futhi uma imiphumela yokuhlolwa kwe-Pap ibonisa amaseli athile angavamile e-vulvar.
- Biopsy: Ukukhishwa kwamaseli noma izicubu ku-vulva ukuze zibukwe ngesibonakhulu udokotela wezifo ukuze ahlole izimpawu zomdlavuza.
- I-Colposcopy: Inqubo lapho kusetshenziswa i-colposcope (insimbi ekhanyisiwe, ekhulisayo) ukuhlola isitho sangasese sowesifazane kanye nomlomo wesibeletho izindawo ezingavamile. Amasampula ezicubu angase athathwe kusetshenziswa i-curette (insimbi emise okwesipuni) noma ibhulashi futhi ahlolwe ngesibonakhulu ukuze kutholakale izimpawu zesifo.
- I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amaza omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi emzimbeni. Le nqubo ibizwa nangokuthi i-nuclear imaging resonance magnetic (NMRI).
- Ukuskena kwe-CT (ukuskena kwe-CAT): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi emzimbeni, ezithathwe kuma-engeli ahlukene. Izithombe zenziwa ikhompuyutha exhunywe kumshini we-x-ray. Udayi ungase ujovwe emthanjeni noma ugwinywe ukuze usize izitho noma izicubu zibonakale ngokucacile. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computerized axial tomography.
- Ukuskena kwe-PET (scan positron emission tomography): Inqubo yokuthola okuyingozi isisu amaseli emzimbeni. Inani elincane leglucose ekhipha imisebe (ushukela) lifakwa emithanjeni. I-PET scanner izungeza umzimba wonke futhi yenza isithombe sokuthi i-glucose isetshenziswa kuphi emzimbeni. Amaseli amathumba ayingozi abonakala ngokugqama esithombeni ngoba asebenza kakhulu futhi athatha i-glucose eningi kunamangqamuzana avamile.
Izigaba zomdlavuza we-vulvar
- Ngemuva kokuthi kutholwe umdlavuza we-vulvar, kwenziwa ukuhlolwa ukuze kutholakale ukuthi amangqamuzana omdlavuza asabalale ngaphakathi kwe-vulva noma kwezinye izingxenye zomzimba.
- Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
- Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
- Ku-vulvar intraepithelial neoplasia (VIN), amaseli angavamile atholakala ebusweni besikhumba se-vulvar.
- Izigaba ezilandelayo zisetshenziselwa umdlavuza we-vulvar:
- Isigaba I
- Isigaba II
- Isigaba III
- Isigaba IV
- Umdlavuza we-Vulvar ungaphinde ubuye (ubuye) ngemva kokwelashwa.
Okunye ukuhlolwa kuyenziwa ukuze kwaziwe ukuthi umdlavuza ususabalele yini kwezinye izingxenye zomzimba:
Inqubo esetshenziselwa ukuthola ukuthi umdlavuza usabalele yini ngaphakathi kwe-vulva noma kwezinye izingxenye zomzimba ibizwa ngokuthi i-staging. Ulwazi oluqoqwe ohlelweni lwesiteji lunquma isigaba sesifo. Kubalulekile ukwazi isiteji ukuze uhlele ukwelashwa. Izivivinyo ezilandelayo nezinqubo zingasetshenziswa enqubeni yesiteji:
- I-cystoscopy: Inqubo yokubheka ngaphakathi esinyeni kanye ne-urethra ukuhlola izindawo ezingavamile. I-cystoscope ifakwa nge-urethra ingene esinyeni. I-cystoscope iyithuluzi elincanyana, elifana neshubhu elinokukhanya kanye nelensi yokubukwa. Ingase futhi ibe nethuluzi lokususa amasampula ezicubu, ahlolwa ngaphansi kwe-a ukuthola izimpawu zomdlavuza.
- Proctoscopy: Inqubo yokubheka ngaphakathi kwe-rectum nedidi ukuhlola izindawo ezingavamile, kusetshenziswa i-proctoscope. I-proctoscope iyithuluzi elincanyana, elifana neshubhu elinokukhanya kanye nelensi yokubuka ingaphakathi le-rectum nedidi. Ingase futhi ibe nethuluzi lokususa amasampula ezicubu, ahlolwa ngesibonakhulu ukuze abone izimpawu zomdlavuza.
- I-X-ray yesifuba: I-x-ray iwuhlobo lwensimbi yamandla ekwazi ukudlula emzimbeni ingene efilimini, yenze isithombe sezindawo ezingaphakathi emzimbeni. Ukuya esigabeni somdlavuza we-vulvar, ama-x-ray angase athathwe ezithweni namathambo ngaphakathi kwesifuba.
- I-Intravenous pyelogram (IVP): Uchungechunge lwama-x-ray ezinso, ureters, nesinye ukuze kutholwe ukuthi umdlavuza ususabalele yini kulezi zitho. Udayi ohlukile ujovwa emthanjeni. Njengoba udayi wokuqhathanisa uhamba ezinso, ureter nesinye, kuthathwa ama-x-ray ukuze kubonakale ukuthi akukho yini ukuvaleka. Le nqubo ibizwa nangokuthi i-urography ye-intravenous.
- Biopsy: Ukukhishwa kwamaseli noma izicubu esinyeni noma i-rectum ukuze zibukwe nge-microscope udokotela ohlola izifo ukuze ahlole izimpawu zomdlavuza, uma kusolwa ukuthi umdlavuza ususabalele lapho.
Ukwelashwa komdlavuza we-vulvar
Ukuhlinzwa
Ukuhlinzwa okusetshenziselwa ukwelapha umdlavuza we-vulvar yilezi:
Ukukhipha: Le nqubo, eyaziwa nangokuthi ukusika okubanzi kwendawo noma ukusika okukhulu, ihlanganisa ukususa ubulwelwe kanye nenani elincane lezicubu ezizungezile ezivamile. Ngokususa umngcele wezicubu ezibukeka ngendlela evamile, odokotela abahlinzayo bangase baqinisekise ukuthi wonke amangqamuzana ayingozi aphelile.
I-Vulvectomy: Amagciwane amakhulu angase adinge ukuhlinzwa ukuze kukhishwe ingxenye ye-vulva (ingxenye ye-vulvectomy) noma i-vulva yonke, kuhlanganise nezicubu ezingaphansi (i-vulvectomy enkulu). Izifo eziyingozi ezinkulu zingazuza ekwelashweni okuhlanganisa imisebe kanye nokwelashwa ngamakhemikhali ukuze kwehliswe isimila ngaphambi kokuhlinzwa, okuvumela inqubo ehlasela kancane.
I-Sentinel node biopsy: Ukuze anqume ukuthi umdlavuza ususabalele yini kuma-lymph nodes, udokotela ohlinzayo angase asebenzise inqubo ebizwa ngokuthi i-sentinel node biopsy. Le nqubo ihlonza ama-lymph nodes okungenzeka ukuthi aqukethe umdlavuza ukuze asuswe futhi ahlaziywe. Uma umdlavuza ungatholakali kulawo ma-lymph nodes okuqala, akunakwenzeka ukuthi ube kunoma iyiphi enye i-lymph nodes.
Ukususa ama-lymph nodes amaningi. Uma umdlavuza ususabalele kuma-lymph nodes, ama-lymph nodes amaningi angase asuswe ukuze kuncishiswe ingozi yokuthi umdlavuza uzosakazekela ezindaweni ezikude zomzimba.
Izinkinga ezivela ekuhlinzeni zihlanganisa ukutheleleka kanye nezinkinga ngokuphulukiswa eduze nokusikwa. Ukususwa kwe-lymph node kungabangela ukugcinwa kwamanzi nokuvuvukala kwemilenze, isifo esaziwa ngokuthi i-lymphedema.
Ukwelashwa ngemisebe ekwelapheni umdlavuza we-vulvar
Ukubulala amangqamuzana omdlavuza, imisebe Ukwelapha kusebenzisa imishayo yamandla enamandla amakhulu njengama-X-ray nama-proton. Ezimweni eziningi, ukwelashwa ngemisebe yomdlavuza we-vulvar kulethwa umshini onyakaza nomzimba wakho futhi usabalalise imisebe ezindaweni ezithile esikhunjeni sakho (imisebe ye-beam yangaphandle).
Ukwelapha ngemisebe ngezinye izikhathi kusetshenziselwa ukunciphisa izimila ezinkulu ze-vulvar ukuze ukuhlinzwa kwenziwe ngempumelelo. I-Chemotherapy kanye nokwelapha ngemisebe ngezinye izikhathi kusetshenziswa ndawonye, okwenza amangqamuzana omdlavuza azwele kakhulu emisebeni.
Uma amangqamuzana omdlavuza etholakala kuma-lymph nodes akho, udokotela wakho angase asikisele ukuthi uthole imisebe endaweni ezungeze ama-lymph nodes ukuze ucekele phansi noma yimaphi amangqamuzana omdlavuza okungenzeka asinda ekuhlinzweni. Kulezi zimo, imisebe ivame ukuhambisana ne-chemotherapy.
I-Chemotherapy ekwelapheni umdlavuza we-vulvar
I-Chemotherapy iwumuthi wokwelapha obulala amangqamuzana omdlavuza ngokusebenzisa amakhemikhali. Imithi yokwelapha ngamakhemikhali ngokuvamile inikezwa ngomlomo noma ngomthambo osengalweni yakho.
I-Chemotherapy ingase ibe inketho yeziguli ezinomdlavuza we-vulvar othuthukile uye kwezinye izingxenye zomzimba.
I-Chemotherapy kanye nokwelashwa ngemisebe ngezinye izikhathi kusetshenziswa ndawonye ukuze kwehliswe izimila ezinkulu ze-vulvar futhi kwenze ukuhlinzwa kusebenze kakhulu. Umdlavuza osudlulele kuma-lymph nodes ungase welashwe ngenhlanganisela yokwelapha ngamakhemikhali nemisebe.
Umdlavuza we-vulvar othuthuke kakhulu ungelashwa ngomuthi owodwa noma eminingi yale mithi:
- Cisplatin
- I-Carboplatin
- IVinorelbine
- I-Paclitaxel
- U-Erlotinib
Imithi yokwelashwa ehlosiwe
Ukwelashwa kwezidakamizwa okuhlosiwe kugxile kokungajwayelekile okuthile okukhona kumaseli omdlavuza. Ngokuvimbela lokhu okungahambi kahle, ukwelashwa kwezidakamizwa okuhlosiwe kungabangela ukuthi amangqamuzana omdlavuza afe.
Ukwelashwa okuhlosiwe kungase kube inketho yokwelapha umdlavuza we-vulvar othuthukile.
immunotherapy
I-Immunotherapy isebenzisa amasosha omzimba wakho ukulwa nomdlavuza. Amasosha omzimba alwa nesifo angase angawuhlaseli umdlavuza wakho ngoba amangqamuzana omdlavuza akhiqiza amaprotheni awasiza ukuba acashe kumaseli amasosha omzimba. I-Immunotherapy isebenza ngokuphazamisa leyo nqubo.
I-Immunotherapy ingase ibe inketho yokwelapha umdlavuza we-vulvar othuthukile.
Thatha umbono wesibili mayelana nokwelashwa komdlavuza we-vulvar
- Amazwana Avaliwe
- Januwari 12th, i-2022
