Umdlavuza womthondo

Umdlavuza womthondo kuwumdlavuza owakheka esikhumbeni noma izicubu zomthondo.Izimpawu zingafaka ukukhula okungajwayelekile, isilonda noma isilonda esikhunjeni sowesilisa, kanye nokopha noma ukukhipha okunuka kabi. 

Penile_Edema_02 

Izici zobungozi zibandakanya i-phimosis (ukungakwazi ukuhoxisa ijwabu lobudoda), ukuvuvukala okungapheli, ukubhema, ukutheleleka nge-HPV, i- condylomata acuminate, ukuba nabalingani abaningi bezocansi, kanye nokuya ocansini usemncane. 

Cishe ama-95% omdlavuza we-penile angama- squamous cell carcinomas .Ezinye izinhlobo zomdlavuza we-penile njenge- Merkel cell carcinoma, i- cell cell carcinoma, ne- melanoma ngokuvamile azivamile. Ku-2018, kwenzeka emadodeni angama-34,000 futhi kwabangela ukufa kwabantu abayi-15,000. 

 Izimpawu 
Umdlavuza wePenile ungabonakala njengokubomvu nokucasula epeni ngesikhumba esijiyile ku-glans noma ijwabu langaphakathi noma isilonda, ukukhula kwangaphandle ( exophytic ) noma ukukhula okufana "nomunwe" (papillary). Umdlavuza wePenile ungahambisana nokukhishwa kwe-penile noma ngaphandle kobunzima noma ukushisa noma ukuhayiza ngenkathi uchama (i- dysuria ) nokuphuma kwegazi endodeni.  

 Izici zobungozi 

 Izifo 

 Ukutheleleka nge-HIV —amadoda ane-HIV anengozi ephindwe kasishiyagalombili yokuthola umdlavuza we-penile kunamadoda angenayo i-HIV. 
 I-human papillomavirus -HPV iyingozi ekuthuthukiseni umdlavuza we-penile.  Ngokusho kweCentre for Disease Control and Prevention (CDC), i-HPV ibhekele cishe i-800 (cishe i-40%) yamacala we-1,570 womdlavuza we-penile otholakala minyaka yonke e-United States.Kunezinhlobo ezingaphezu kuka-120 ze-HPV. 
 Ama-genital warts -Izinsumpa zangasese noma ze-perianal zandisa ubungozi besifo somdlavuza we-penile ongahlaseli cishe izikhathi ezingama-3.7 uma kwenzeka ngaphezulu kweminyaka emibili ngaphambi kosuku lokubhekiswa. Cishe uhhafu wamadoda anomdlavuza we-penile nawo anezinsumpa zangasese, ezibangelwa i-HPV. 

 I-Pathogenesis 
Kuphakama umdlavuza Penile kusuka eyandulela izilonda, okuyinto ngokuvamile bathuthuke kusukela ephansi kulibanga ephezulu grade izilonda.Kumdlavuza we-penile ohlobene ne-HPV lokhu kulandelana kanje: Bleeker MC, Heideman DA, Snijders PJ, Horenblas S, Dillner J, Meijer CJ (April 2009). "Penile cancer: epidemiology, pathogenesis and prevention". World Journal of Urology. 27 (2): 141–50. doi:10.1007/s00345-008-0302-z. PMID 18607597. S2CID 25742226.

 I-squplus hyperplasia ;
 I-penile intraepithelial neoplasia esezingeni eliphansi (i-PIN);
 I-PIN esezingeni eliphakeme (i-carcinoma in situ— Isifo sikaBowen, i- Erythroplasia yaseQueyrat ne- bowenoid papulosis (BP));
 I-carcinoma ehlaselayo yomthondo.

Kodwa-ke, kwezinye izimo izilonda ezingezona eze-dysplastic noma ezinesizungu ezingadlulela ngqo zingaba nomdlavuza.Izibonelo zifaka izilonda ze-penile flat (FPL) ne- condylomata acuminata . 

Ku- HPV umdlavuza ongemuhle isilonda esandulele kakhulu yi- lichen sclerosus (LS). 

 Ukuxilongwa 
I-International Society of Urological Pathology (ISUP) incoma ukusetshenziswa kwe- p16 INK4A immunostain for the diagnostic and classification of HPV-related penile cancer. 

 Ukuhlukaniswa 
Cishe ama-95% omdlavuza we-penile angama- squamous cell carcinomas .Zihlukaniswe ngezinhlobo ezilandelayo:

 i-basaloid (4%)
 insumpa (6%)
 i-warty-basaloid exubile (17%)
 i-verrucous (8%)
 i-papillary (7%)
 enye i-SCC ixubile (7%)
 i-sarcomatoid carcinomas (1%)
 akuchaziwe ngenye indlela (49%)

Ezinye izinhlobo ze-carcinomas azivamile futhi zingafaka iseli elincane, i- Merkel cell, i- cell ecacile, i-sebaceous cell noma i- basal cell tumors.Izilonda ezingekho epithelial ezifana nama- melanomas nama- sarcomas zivame kakhulu. 

 Isiteji 
Njengamakhemikhali amaningi amabi, umdlavuza we-penile ungasakazekela kwezinye izitho zomzimba.Ngokuvamile kuyisifo esiyinhloko, indawo yokuqala lapho umdlavuza usakazeka khona emzimbeni.Kancane kancane kuyisifo esibuhlungu sesibili, lapho umdlavuza usabalalele khona endondeni kusuka kwenye indawo.Ukufakwa komdlavuza we-penile kunqunywa ubukhulu bokuhlasela kwesimila, i-nodal metastasis, kanye ne-metastasis ekude. 

Ingxenye ye-T yemihlahlandlela yesiteji ye-AJCC TNM ingeyesimila sokuqala ngokulandelayo: 

 I-TX: Isigaxa sokuqala asikwazi ukuhlolwa.
 I-T0: Akunabufakazi besimila esiyinhloko.
 I-Tis: I-Carcinoma in situ .
 I-Ta: I-carcinoma engabonakali ehlaselayo.
 I-T1a: Isimila sihlasela izicubu ezihlangene ezingaphansi kwe-lymph vascular invasion futhi asihlukaniswanga kahle (okungukuthi, ibanga lesi-3-4).
 I-T1b: Isimila sihlasela izicubu ezixhuma ngaphansi kwe-lymph ngokuhlasela kwe-lymph vascular noma sihlukaniswe kabi.
 I-T2: Isimila sihlasela i-corpus spongiosum noma i-cavernosum.
 I-T3: I-tumor ihlasela i-urethra noma i-prostate.
 I-T4: Isimila sihlasela ezinye izakhiwo eziseduze.

I-Anatomic Stage noma Amaqembu Okuqagela umdlavuza we-penile ami kanjena: 

 Isigaba 0 — I-Carcinoma in situ .
 Isigaba I-Umdlavuza uhlukaniswe ngokulingene noma kahle futhi uthinta kuphela izicubu ezixhumene ne-subepithelial.
 Isigaba II — Umdlavuza wehlukaniswe kabi, uthinta ama-lymphatics, noma uhlasela i-corpora noma i-urethra.
 Isigaba IIIa — Kunokuhlasela okujulile ethweni lobudoda nakwe-metastasis ku-lymph node eyodwa.
 Isigaba IIIb — Kunokuhlasela okujulile ethweni lobudoda nakwe-metastasis kuma-lymph node amaningi we-inguinal.
 Isigaba IV — Umdlavuza uhlasele ezakhiweni ezincikene nepipi, kufakwa imastastas node ye-pelvic, noma i-metastasis ekude ikhona.

 Izimila ezinhle ze-HPV 
Ukudlanga kwabantu i-papillomavirus kumdlavuza we-penile kuphakeme cishe ngama-40%. I-HPV16 yi-genotype ebaluleke kakhulu ebala cishe izicubu ezingama-63% zama-HPV-positive.Phakathi komdlavuza we-warty / basaloid ukwanda kwe-HPV kungama-70-100% kanti kwezinye izinhlobo kucishe kube ngu-30%. 

 Ukuvimbela 

 Imishanguzo ye-HPV efana neGardasil noma iCervarix inganciphisa ubungozi be-HPV futhi, ngenxa yalokho, umdlavuza we-penile.  
 Ukusetshenziswa kwamakhondomu kucatshangwa ukuthi kuyazivikela emdlavuzeni ophathelene ne-HPV penile. 
 Ukuhlanzeka okuhle kwezitho zobulili, okubandakanya ukugeza ipipi, isikhumba, nejwabu nsuku zonke ngamanzi, kungavimbela i-balanitis nomdlavuza we-penile. Noma kunjalo, insipho enezithako ezinzima kufanele igwenywe.
 Ukuphela kokubhema kunganciphisa ingozi yomdlavuza we-penile. Pow-Sang MR, Ferreira U, Pow-Sang JM, Nardi AC, Destefano V (August 2010). "Epidemiology and natural history of penile cancer". Urology. 76 (2 Suppl 1): S2-6. doi:10.1016/j.urology.2010.03.003. PMID 20691882.
 Ukusoka ngesikhathi sobuntwana noma ebuntwaneni kungahlinzeka ngokuvikelwa okuyingxenye kumdlavuza we-penile. Ababhali abaningana baphakamise ukusoka njengecebo elingenzeka lokuvikela umdlavuza we-penile;    kodwa-ke, i-American Cancer Society ikhomba ukuthi lesi sifo siyivelakancane futhi iphawula ukuthi i-American Academy of Pediatrics noma iCanada Academy of Pediatrics ayikukhuthazi ukusoka okwenzeka njalo ngaphambi kokubeletha. 
 I-Phimosis ingavinjelwa ngokwenza inhlanzeko efanele nokubuyisa ijwabu njalo. 
 I-Paraphimosis ingavinjelwa ngokungashiyi ijwabu lihoxiswe isikhathi eside. 

 Ukwelashwa 
Ukwelashwa komdlavuza we-penile kuzohluka ngokuya ngesigaba somtholampilo sesimila ngesikhathi sokuxilongwa.Kunezinketho eziningi zokwelashwa komdlavuza we-penile, kuya ngesiteji.Kubandakanya ukuhlinzwa, ukwelashwa ngemisebe, ukwelashwa ngamakhemikhali kanye nokwelashwa kwezinto eziphilayo.Ukwelashwa okuvame kakhulu kungenye yezinhlobo ezinhlanu zokuhlinzwa:

 Ukusikwa kwendawo yonke — isisu nezinye izicubu ezinempilo ezizungezile ziyasuswa
 I- microsurgery —ukuhlinzwa okwenziwa ngesibonakhulu kusetshenziselwa ukususa isimila nezicubu ezincane ezinempilo ngangokunokwenzeka
 Ukuhlinzwa nge-Laser —isibani selaser sisetshenziselwa ukushisa noma ukusika amaseli anomdlavuza
 Ukusoka — ijwabu elinomdlavuza liyasuswa
 Ukunqunywa (i- penectomy) —ukususwa kwesitho sangasese ngokuphelele noma ngokuphelele, futhi mhlawumbe nama- lymph node ahambisanayo.

Indima yokwelashwa ngemisebe ifaka phakathi indlela yokulondolozwa komzimba yomdlavuza wepenile osezingeni lokuqala ezikhungweni ezikhethekile.Ngaphezu kwalokho, i-adjuvant therapy isetshenziselwa iziguli ezinesifo esithuthukile endaweni noma ukuphatha izimpawu. 

 Isibikezelo 
Isibikezelo singahluka kakhulu ezigulini, kuya ngokuthi sikalwe kuphi.Ngokuvamile, lapho umdlavuza utholakala ngokushesha, kungcono ukubikezelwa.Izinga lokusinda leminyaka emihlanu yonke yazo zonke izigaba zomdlavuza we-penile cishe liyi-50%. 

 I-Epidemiology 
Umdlavuza wePenile wumdlavuza ongajwayelekile emazweni athuthukile okwenzeka minyaka yonke okuhluka kusuka ku-0.3 kuye ku-1 kwabangu-100,000 ngonyaka kubalwa cishe i-0.4-0.6% yazo zonke izifo ezimbi. I-annual kwesifo cishe 1 ezingabantu 100,000 e-United States, The American Cancer Society: Penile Cancer: What is penile cancer?  American Cancer Society, Last revised: January 8, 2012 e-1 250,000 e-Australia, The Official Website of the Royal Australasian College of Physicians, Published September 2010 kanye 0,82 ngamunye 100,000 eDenmark. E-United Kingdom, abesilisa abangaphansi kwama-500 abatholakala benomdlavuza we-penile minyaka yonke. The American Cancer Society: Penile Cancer: What are the key statistics about penile cancer  American Cancer Society, Last revised: January 18, 2012

Kodwa-ke, emazweni asathuthuka umdlavuza we-penile uvame kakhulu.Isibonelo, eParaguay, e- Uruguay, e- Uganda naseBrazil izehlakalo eziyi-4.2, 4.4, 2.8 no-1.5-3.7 ku-100,000 ngamunye, ngokulandelana.  Kwamanye amazwe aseNingizimu Melika, e-Afrika, nase-Asia, lolu hlobo lomdlavuza lwenza kufinyelela ku-10% wezifo ezibulalayo emadodeni. 

Ingozi yokuphila konke ilinganiselwa ku-1 kwabangu-1,437 e-United States naku-1 kwabangu-1,694 eDenmark. 

 Izinkomba 

Category:Umthondo womuntu
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