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პროსტატის კიბო

თარიღი: 19 სექტემბერი, 2025

როგორია პროსტატის ჯირკვალი, რას წარმოადგენს პროსტატის კიბო და რა უნდა იცოდეს ყველა მამაკაცმა? – ამ თემაზე გვესაუბრება კლინიკური ონკოლოგიის ინსტიტუტის უროლოგი მამუკა მჭედლიძე.

პროსტატის ჯირკვალი
პროსტატის ჯირკვალი პატარა ორგანოა, რომელიც შედგება ჯირკვლოვანი და კუნთოვანი ქსოვილისგან და მდებარეობს უშუალოდ შარდის ბუშტის ქვეშ. იგი ფარავს შარდის ბუშტის ყელსა და პროქსიმალურ შარდსადენს.

 

მისი მთავარი ფუნქციაა პროსტატის წვენის გამომუშავება, რაც ხელს უწყობს სპერმის სიცოცხლისუნარიანობას. დაახლოებით 20 წლის ასაკში პროსტატის ჯირკვალი აღწევს ბუნებრივ ზომას და ზრდას წყვეტს.

• ნორმალური მოცულობა: 23–25 სმ³

• საშუალო წონა: 20–23 გრამი

რას წარმოადგენს პროსტატის კიბო?
პროსტატის კიბო ერთ-ერთი ყველაზე გავრცელებული ონკოლოგიური დაავადებაა. ის მამაკაცებში დიაგნოზირებული ავთვისებიანი სიმსივნეების 14%-ზე მეტს შეადგენს.

დაავადება ხშირად ნელა ვითარდება და წლების განმავლობაში შეიძლება სრულიად უსიმპტომოდ მიმდინარეობდეს. სწორედ ამიტომ, ხშირად აღმოაჩენენ II სტადიაზე ან უფრო გვიან, როცა სიმსივნე უკვე ზეწოლას ახდენს შარდსადენზე. ადრეული დიაგნოზი კრიტიკულად მნიშვნელოვანია — სწორედ ის იძლევა ეფექტური მკურნალობის შანსს და საშიში შედეგების (მეტასტაზები ძვლებში და შინაგან ორგანოებში) თავიდან აცილებას.

პირველი სიმპტომები
პროსტატის კიბოს სიმპტომები ჩნდება მაშინ, როდესაც სიმსივნე იწყებს შარდსადენის დაჭერას:
• ტკივილი შარდვის დროს

• წყვეტილი შარდის ნაკადი, შარდვის ბოლოს — წვეთოვანი გამოყოფა

• შარდვის გახშირებული სურვილი (მათ შორის ღამით)

• მცირე რაოდენობით შარდის გამოყოფა

• შარდის ბუშტის არასრული დაცლის შეგრძნება

• ერექციული დისფუნქცია

• ტკივილი ეაკულაციის დროს

• ტკივილი მუცლის ქვედა ნაწილში, შორისში ან წელის ქვედა ნაწილში

• სისხლი შარდში და/ან სპერმაში

• ზეწოლის შეგრძნება ანუსის მიდამოში

მკურნალობის გარეშე სიმსივნე შეიძლება გავიდეს პროსტატის კაფსულას გარეთ და მოახდინოს მეტასტაზირება სხვა ორგანოებში.

რისკ-ფაქტორები
მეცნიერებას ჯერ არ შეუძლია პროსტატის კიბოს ზუსტი მიზეზების სრული დადგენა, თუმცა ცნობილი რისკ-ფაქტორებია:

• ასაკი (70%-ზე მეტი შემთხვევა ვლინდება 65 წელს გადაცილებულებში)

• მემკვიდრეობითი ფაქტორი (პროსტატის ან ძუძუს კიბო ახლო ნათესავებში)

• ჰორმონალური და იმუნური დარღვევები

• ქრონიკული ანთებითი დაავადებები

• არაბალანსირებული კვება (ჭარბი ცხიმი, ანტიოქსიდანტებისა და ფიტოესტროგენების დეფიციტი)

• A ვიტამინისა და ბეტა-კაროტინის ნაკლებობა

• ფიზიკური უმოქმედობა

• მოწევა

დიაგნოსტიკა

პროსტატის კიბოს სიმპტომები ხშირად ჰგავს კეთილთვისებიანი ჰიპერპლაზიის, ინფექციებისა და პროსტატიტის ნიშნებს. ამიტომ თვითმკურნალობა დაუშვებელია.

 

პირველი ნაბიჯი არის PSA (პროსტატის სპეციფიკური ანტიგენი) სისხლის ანალიზი — საქართველოში 50 წლიდან სკრინინგი უფასოა. დიაგნოზის დასაზუსტებლად ტარდება:

• პროსტატის ბიოფსია

• მაგნიტურ-რეზონანსული ტომოგრაფია (MRI)

• კომპიუტერული ტომოგრაფია (CT) და სხვა კვლევები

მკურნალობა
თანამედროვე მედიცინას აქვს პროსტატის კიბოს სამკურნალო მრავალი მეთოდი.

• ადრეულ სტადიაზე — ქირურგიული მკურნალობა (პროსტატის და ირგვლივმდებარე ლიმფური კვანძების ამოკვეთა). ოპერაცია შეიძლება ჩატარდეს ღია, ლაპაროსკოპიული ან რობოტ-ასისტირებული მეთოდით.

• გავრცელებულ სტადიაზე — გამოიყენება მულტიმოდალური მიდგომა: ჰორმონოთერაპია, ქიმიოთერაპია, სხივური თერაპია — როგორც დამოუკიდებლად, ასევე კომბინირებულად.

დასკვნა

პროსტატის კიბო — ნელა მზარდი, მაგრამ სერიოზული დაავადებაა. ადრეულ სტადიაზე ის წარმატებით იკურნება. სწორედ ამიტომ გადამწყვეტია:

• რეგულარული სკრინინგი

• საგანგაშო სიმპტომებზე დროული რეაგირება

• თანამედროვე გაიდლაინების მიხედვით მკურნალობა