Umhlaza wamatyhalarha luhlobo lomhlaza okhula kumasende, wona angamadlala azala amadoda abekwe ngaphakathi kwisingxobo samatyhalarha. Amasende anoxanduva lokuvelisa isidoda kunye ne testosterone, eyona hormone yesini yamadoda. Umhlaza wamatyhalarha udla ngokuqala kwiiseli zentsholongwane, eziziseli ezivelisa amadlozi. Nangona kunjalo, inokukhula nakwezinye iindidi zeeseli ngaphakathi kwamasende, njengezicubu ezixhasayo okanye iiseli ezivelisa ihomoni.
Umhlaza wamatyhalarha unqabile xa uthelekiswa neminye iintlobo zomhlaza, kubalwa kuphela malunga ne-1% yazo zonke ii-cancer emadodeni. Nangona kunjalo, ngowona mhlaza uxhaphakileyo kubafana abancinci abaphakathi kweminyaka eyi-15 kunye ne-35. Nangona inokwenzeka nakweyiphi na iminyaka, idla ngokufunyaniswa ngeli xesha. Umhlaza wamatyhalarha uyanyangeka kakhulu, ngakumbi xa ufunyenwe kwangoko. Nangona kunjalo, ukuxilongwa ngokukhawuleza kunye nonyango luyimfuneko kwisiphumo esihle kakhulu.
Iintlobo zomhlaza wamatyhalarha
Umhlaza wamatyhalarha ubonakala ngokuyintloko kwiindidi ezimbini eziphambili: amathumba eeseli zentsholongwane kunye namathumba eeseli ezingezizo iintsholongwane.
a. Iintsholongwane zeeseli zeentsholongwane
Amathumba eeseli zentsholongwane asuka kwiiseli zentsholongwane ngaphakathi kwamasende, ezinoxanduva lokuvelisa amadlozi. Benza uninzi lwezehlo zomhlaza wamatyhalarha kwaye zohlulwa kwakhona zibe ziintlobo ezincinci:
- I-Seminomas: I-Seminomas luhlobo lwe-germ cell tumor eyenzeka emadodeni phakathi kweminyaka yamashumi amabini kunye namashumi amane okuqala. La mathumba athambekele ekukhuleni ngokucothayo kwaye anyangeka kakhulu, nakwinqanaba eliphezulu. I-Seminomas ihlala ivalelwe kwi-testicle kwaye ine-prognosis elungileyo.
- I-non-seminomas: I-non-seminomas ibandakanya ii-subtypes ezininzi, kuquka i-embryonal carcinoma, i-yolk sac carcinoma, i-choriocarcinoma, i-teratoma, kunye ne-mixed germ cell tumors. Ii-non-seminomas zihlala zindlongondlongo kunee-seminomas kwaye zinokusasazeka ngokukhawuleza. Ngokuqhelekileyo zifunyaniswa kumadoda amancinane kwaye zinokufuna unyango olunzulu.
b. Amathumba eeseli ezingezizo iintsholongwane
Amathumba eeseli ezingezizo iintsholongwane aphuhla kwiithishu ezixhasayo kunye nezivelisa ihomoni ngaphakathi kwamasende, kunokuba zisuke kwiiseli zentsholongwane ngokwazo. Ngelixa ixhaphake kakhulu kunee-germ cell tumors, zisamele i-subset ye-testicular cancers. Imizekelo yamathumba eeseli ezingezizo iintsholongwane ziquka:
- I-Leydig cell tumors: I-Leydig cell tumors ivela kwiiseli zeLeydig, ezivelisa i-testosterone kumasende. Ezi thumba zihlala zinobungozi (zingekho umhlaza) kodwa ngamanye amaxesha zinokuba yingozi.
- Amathumba eeseli zeSertoli: Iiseli zeSertoli zikhula ukusuka kwiiseli zeSertoli, ezibonelela ngenkxaso kunye nesondlo kwiiseli ezivelisa amadlozi. Njengamathumba eeseli zeLeydig, iiseli zeSertoli ziqhelekile kodwa zinokuba yingozi kwezinye iimeko.
Oonobangela bomhlaza wamatyhalarha
Oyena nobangela womhlaza wamatyhalarha awuqondwa ngokupheleleyo, kodwa iimeko ezininzi zomngcipheko ziye zachongwa ezinokwandisa amathuba okuba sisifo. Le miba yomngcipheko ibandakanya:
a. I-Testicle engapheliyo (Cryptorchidism)
Amadoda azelwe enesende elinye okanye omabini angazange ehle kwi-scrotum (cryptorchidism) anomngcipheko omkhulu wokuba nomhlaza wamatyhalarha. Kukholelwa ukuba indawo engaqhelekanga ye-testicle yandisa amathuba okuba nokuguqulwa okubi.
b. Imbali yosapho
Ukuba nembali yosapho lomhlaza wamatyhalarha kwandisa umngcipheko wokuba nesi sifo. Amadoda anotata okanye umnakwabo onomhlaza wamatyhalarha asemngciphekweni omkhulu xa kuthelekiswa nalawo angenayo imbali yosapho. Nangona kunjalo, uninzi lweemeko zomhlaza wamatyhalarha zenzeka kumadoda angenayo imbali yosapho yesi sifo.
c. Imiba yemfuza
Iimeko ezithile zofuzo, ezifana ne-Klinefelter syndrome, zinokunyusa umngcipheko womhlaza wamatyhalarha. I-Klinefelter syndrome sisifo se-chromosomal apho amadoda azalwa ene-X chromosome eyongezelelweyo (XXY endaweni ye-XY). Ezinye iziphazamiso zemfuza nazo zinokuba negalelo ekonyukeni komngcipheko womhlaza wamatyhalarha.
d. Usulelo lwe-HIV
Olunye uphononongo lucebise ikhonkco phakathi kosulelo lwe-HIV kunye nomngcipheko owongezelelweyo womhlaza wamatyhalarha. Amajoni omzimba abuthathaka anxulunyaniswa ne-HIV/AIDS anokuba negalelo ekukhuleni kweentlobo ezithile zomhlaza, kuquka nomhlaza wamatyhalarha.
e. Imiba yokusingqongileyo
Ukuvezwa kwizinto ezithile zokusingqongileyo kunokudlala indima ekuphuhliseni umhlaza wamatyhalarha, nangona ubungqina bungagqibekanga. Olunye uphononongo lucebise ukuba kukho ikhonkco elinokubakho phakathi kokuvezwa kwizitshabalalisi, iikhemikhali, okanye ityhefu yokusingqongileyo kunye nomngcipheko owongeziweyo womhlaza wamatyhalarha. Nangona kunjalo, uphando oluninzi luyafuneka ukuseka ubudlelwane obucacileyo be-causal.
f. Ukwenzakala kwamatyhalarha okanye ukwenzakala
Kukho ubungqina obulinganiselweyo obubonisa ukuba ukwenzakala okanye ukwenzakala kwamasende kunokunyusa umngcipheko womhlaza wamatyhalarha. Nangona kunjalo, umbutho phakathi kwe-testicular trauma kunye nophuhliso lomhlaza awumiselwanga kakuhle, kwaye uphando olongezelelweyo luyafuneka ukucacisa olu budlelwane.
Iimpawu zomhlaza wamatyhalarha
Umhlaza wamatyhalarha udla ngokuba neempawu ezibonakalayo, nangona ezinye iimeko zisenokungabi nazimpawu kwaye zibonwe kuphela ngexesha lovavanyo lwesiqhelo lomzimba okanye uhlolo. Kubalulekile ukuba amadoda azazi ezi mpawu zilandelayo zomhlaza wamatyhalarha.
a. Iqhuma okanye ukudumba kwisende
Olona phawu luqhelekileyo lomhlaza wamatyhalarha bubukho beqhuma elingenantlungu okanye ukudumba kwelinye lamasende. Eli qhuma lisenokuvakala ngathi lincinci, ubunzima okanye ukudumba okukhulu okuthambileyo. Kubalulekile ukuba amadoda azihlole rhoqo amatyhalarha ukuze abone naluphi na utshintsho kubungakanani, ukumila, okanye ukungaguquguquki kwamasende.
b. Intlungu okanye ukungakhululeki
Ngelixa umhlaza wamatyhalarha usoloko ungenantlungu, amanye amadoda anokuba neentlungu ezibuhlungu okanye ukungakhululeki kwisende okanye kwisingxobo esichaphazelekayo. Oku kuphazamiseka kunokuthi kube rhoqo okanye kuphazamiseke kwaye kunokukhanya kumazantsi esisu okanye kwindawo ye-groin.
c. Utshintsho kubungakanani betyhalarha okanye imilo
Umhlaza wamatyhalarha unokubangela utshintsho kubungakanani okanye ukumila kwetyhalarha elichaphazelekayo. Amadoda angaqaphela ukuba elinye ityhalarha livakala likhulu okanye linzima kunelinye, okanye ityhalarha elichaphazelekayo limile ngendlela engaqhelekanga okanye ligqwethekile.
d. Ukuziva ubunzima kwisingxobo sesingxobo
Amanye amadoda anomhlaza wetyhalarha anokuba namava obunzima, uxinzelelo, okanye ukugcwala kwisingxobo samatyhalarha. Le mvakalelo inokukhatshwa kukungakhululeki okanye ukungakhululeki.
e. Intlungu okanye ukungahambi kakuhle kwisisu esisezantsi okanye kwi-groin
Kwezinye iimeko, umhlaza wetyhalarha unokubangela intlungu okanye ukungakhululeki kumazantsi esisu okanye kwindawo yegroin. Le ntlungu inokuba yincinci okanye iphakathi kwaye inokuthi iqhutywe ngumsebenzi womzimba okanye ixesha elide lokuhlala okanye lokuma.
f. Ukukhula kwebele okanye ukuthamba
Iindidi ezithile zomhlaza wamatyhalarha, ezinje ngamathumba eeseli zentsholongwane, zinokuvelisa iihomoni ezinokubangela ukwanda kwebele okanye ukuthamba emadodeni. Le meko, eyaziwa ngokuba yi-gynecomastia, ingenzeka kunye nezinye iimpawu zomhlaza wamatyhalarha.
Amanqanaba omhlaza wamatyhalarha
Ukuma komhlaza wamatyhalarha kubalulekile ekumiseleni ubungakanani besifo kunye nezigqibo ezikhokelayo zonyango. Inkqubo yokubeka eqhele ukusetyenziselwa umhlaza wamatyhalarha yinkqubo ye-TNM, evavanya ithumba eliphambili (T), i-lymph nodes (N), kunye ne-distasis metastasis (M).
Inqanaba 0 (Carcinoma in situ)
Iiseli zomhlaza zivaleleke kumbindi wethishu ngaphakathi kwetyhalarha kwaye azinwenwanga ngaphaya kwetyhalarha. Kweli nqanaba, umhlaza uthathwa ngokuba ungeyo-invasive kwaye awukaphuhli ube lithumba. I-Carcinoma in situ idla ngokufunyanwa ngengozi ngexesha le-biopsies eyenziwa ngenxa yezinye izizathu kwaye ine-prognosis egqwesileyo ngokuqwalaselwa ngokusondeleyo.
Isigaba I
Umhlaza uhlala kwityhalarha kwaye unokubandakanya i-epididymis okanye i-spermatic cord kodwa ayikanwenwanga kwii-lymph nodes ezikufutshane okanye kumalungu akude. Inqanaba I lohlulwe kwakhona laba ngamanqanaba angaphantsi amabini:
- Inqanaba IA: Umhlaza ulinganiselwe kwityhalarha kwaye awubandakanyi imithambo yegazi okanye imithambo ye-lymphatic. Ithumba lincinci kune-2 centimeters (cm) ngobukhulu.
- Inqanaba IB: Umhlaza usasazeke kwimithambo yegazi, imithambo ye-lymphatic, okanye zombini, ngaphakathi kwetyhalarha. I-tumor inokuba nkulu kune-2 cm ngobukhulu kodwa ayizange isasazeke kwii-lymph nodes ezikufutshane okanye kwizitho ezikude.
Isigaba II
Umhlaza usasazeke kwi-lymph nodes ezikufutshane kwisisu okanye kwi-pelvis kodwa awuzange usasazeke kumalungu akude. Inqanaba II lohlulwe kwakhona langamanqanaba angaphantsi amabini:
- Inqanaba IIA: Umhlaza usasazeke kwi-lymph nodes esiswini, i-pelvis, okanye zombini, kodwa i-lymph node enkulu enomhlaza ingaphantsi kwe-2 cm ngobukhulu.
- Inqanaba le-IIB: Umhlaza usasazeke kwi-lymph nodes kwisisu, i-pelvis, okanye zombini, kwaye i-lymph node enkulu equkethe umhlaza yi-2 cm okanye inkulu ngobukhulu.
Isigaba III
Umhlaza usasazeke kumalungu akude, njengemiphunga, isibindi, okanye ingqondo, kwaye unokubandakanya i-lymph nodes ezikufutshane. ISigaba III sahlulwe kwakhona ngokwamanqanaba amabini angaphantsi:
- Inqanaba IIIA: Umhlaza usasazeke kwi-lymph nodes ezikude okanye kwizitho ezingaphaya kwesisu kunye ne-pelvis, njengemiphunga.
- Inqanaba IIIB: Umhlaza usasazeke kakhulu kwizitho ezikude, ezifana nesibindi okanye ingqondo, kwaye zinokubandakanya i-lymph nodes ezikufutshane.
Ukuthintelwa komhlaza wamatyhalarha
Ukuthintela umhlaza wamatyhalarha ngokupheleleyo akusoloko kusenzeka ngenxa yezinto ezifana nemfuzo kunye nokungahambi kakuhle kokukhula. Nangona kunjalo, kukho amanyathelo abantu abanokuthi bawathathe ukunciphisa umngcipheko wabo kunye nokukhuthaza ukufunyanwa kwangoko.
a. Yenza iiMviwo zokuzihlola rhoqo zamatyhalarha (TSE)
Amadoda kufuneka aqhelane nobukhulu, imilo, kunye nobume bamasende kwaye enze ii-TSE ngenyanga. I-TSE ibandakanya ukuva tyhalarha ngobunono phakathi kweminwe noobhontsi ukuze kubonwe naluphi na utshintsho olufana namaqhuma okanye ukudumba. Nakuphi na ukungahambi kakuhle kufuneka kuxelwe ngokukhawuleza kumboneleli wezempilo.
b. Jongana nezinto ezinobungozi
Amadoda anemiba eyaziwayo esemngciphekweni womhlaza wamatyhalarha, njengembali yosapho lwesi sifo okanye imbali yobuqu yamasende angekagqibi (cryptorchidism), kufuneka axoxe ngomngcipheko wawo kunye nomboneleli wezempilo. Ukuhlolwa rhoqo okanye ukubekw' esweni kunokucetyiswa kubantu abasengozini ephezulu.
c. Khusela kwi-HIV
Olunye uphononongo lucebisa ikhonkco phakathi kosulelo lwe-HIV kunye nomngcipheko owonyukayo womhlaza wamatyhalarha. Ukwabelana ngesondo ngendlela ekhuselekileyo, ukusebenzisa iikhondom, kunye nokuphepha indlela yokuziphatha esemngciphekweni omkhulu kunokuncedisa ukunciphisa umngcipheko wosulelo lwe-HIV kwaye kunokwehlisa ingozi yomhlaza wamatyhalarha kubantu abathile.
d. Gcina uphila ubomi obusempilweni
Ukwamkela imikhwa esempilweni, enjengokutya ukutya okunesondlo, ukugcina ubunzima obusempilweni, kunye nokwenza umthambo rhoqo, kunokunceda ukunciphisa umngcipheko womhlaza ngokubanzi. Ukutya okutyebileyo kwiziqhamo, imifuno, ukutya okuziinkozo, kunye neeprotheni ezibhityileyo zibonelela ngezondlo eziyimfuneko kunye ne-antioxidants ezixhasa impilo yonke kwaye zinokunciphisa umngcipheko womhlaza.
e. Kuphephe ukuchanabeka kwityhefu yendalo esingqongileyo
Nangona ubungqina bunqongophele, ezinye iiphononongo zicebisa unxibelelwano olunokwenzeka phakathi kokuvezwa kwi-toxins ethile yendalo, efana ne-pesticides okanye iikhemikhali, kunye nomngcipheko okhulayo womhlaza we-testicular. Ukunciphisa ukuvezwa kwe-carcinogens kwindawo yokusebenza, ikhaya, okanye indawo engqongileyo kunokuncedisa ukunciphisa umngcipheko womhlaza.
f. Ukuhlolwa rhoqo ngugqirha
Uhlolo lwesiqhelo lwezonyango luvumela ababoneleli bezempilo ukuba babeke iliso kwimpilo yonke kwaye babone nakuphi na ukungaqhelekanga okanye utshintsho olunokuthi lufune ukuphononongwa ngakumbi. Amadoda kufuneka axoxe nomboneleli ngononophelo lwezempilo ngemiba yomngcipheko wawo womhlaza wamatyhalarha kwaye abambelele kwizikhokelo zovavanyo ezicetyiswayo.
Ukuxilongwa komhlaza wetyhalarha
Ukufunyaniswa komhlaza wamatyhalarha kubandakanya indibaniselwano yophononongo lwembali yonyango, uvavanyo lomzimba, iimvavanyo zokucinga, kunye novavanyo lwaselabhoratri.
a. Imbali yezonyango kunye nokuhlolwa komzimba
Umboneleli wezempilo uya kuqala ngokuthatha imbali yonyango ngokucokisekileyo, kubandakanywa naziphi na iimpawu ezifunyenweyo kunye nazo naziphi na izinto ezinobungozi obufanelekileyo, njengembali yosapho okanye iimeko zangaphambili zamasende. Uvavanyo lomzimba luya kwenziwa ukuvavanya amasende, i-scrotum, kunye nendawo ye-groin malunga nayo nayiphi na into engaqhelekanga, efana namaqhuma, ukudumba, okanye utshintsho kubukhulu okanye ukuthungwa.
b. Umfanekiso we-Ultrasound
Ukuba iqhuma okanye ukungaqhelekanga kufunyenwe ngexesha lokuhlolwa komzimba, isinyathelo esilandelayo sihlala sisenza i-ultrasound ye-scrotum. I-Ultrasound imaging isebenzisa amaza omsindo aphezulu-frequency ukudala imifanekiso ecacileyo yamasende kunye nezicubu ezijikelezileyo. Olu vavanyo lomfanekiso lunokunceda ekumiseleni ubungakanani, indawo, kunye neempawu zazo naziphi na izihlwele okanye izinto ezingaqhelekanga ngaphakathi kwamasende.
c. Uvavanyo lwegazi
Uvavanyo lwegazi lunokusetyenziselwa ukulinganisa amanqanaba eempawu ezithile zethumba ezihlala ziphakanyiswe kumadoda anomhlaza wamatyhalarha. Ezona mpawu zixhaphakileyo zokumakishwa kwethumba kumhlaza wamatyhalarha ziquka:
- I-Alpha-fetoprotein (AFP): Amanqanaba aphakamileyo e-AFP angabonisa ubukho beentlobo ezithile zomhlaza we-testicular, ezifana ne-non-seminomatous germ cell tumors.
- I-Beta-human chorionic gonadotropin (β-hCG): Amanqanaba aphezulu e-β-hCG anokubakho kuzo zombini iiseli ze-seminomatous kunye ne-non-seminomatous germ cell.
- I-Lactate dehydrogenase (LDH): Amanqanaba e-LDH anokunyuswa kwiindidi ezahlukeneyo zomhlaza, kuquka nomhlaza wamatyhalarha. Nangona kunjalo, i-LDH ayithethi ngokuthe ngqo kumhlaza we-testicular njenge-AFP kunye ne-β-hCG.
Olu vavanyo lwegazi lunceda ababoneleli bezempilo ukuba bahlole uhlobo lomhlaza wamatyhalarha, bajonge impendulo kunyango, kwaye babone nakuphi na ukuphinda kwesi sifo.
d. I-Biopsy
Kwezinye iimeko, i-biopsy inokwenziwa ukuqinisekisa ubukho beeseli zomhlaza. I-biopsy ibandakanya ukususa isampulu encinci yethishu kwityhalarha ukuze ihlolwe phantsi kwemakroskopu ngugqirha wezifo. Nangona kunjalo, i-biopsies ayiqhelekanga ukwenza umhlaza wetyhalarha ngenxa yomngcipheko wokusasaza iiseli zomhlaza. Kunoko, ukuxilongwa ngokuqhelekileyo kusekelwe kwiimvavanyo zemifanekiso, iimvavanyo zegazi, kunye nobukho beempawu zempawu.
e. Izifundo zokufanekisa
Izifundo ezongezelelweyo zokucinga, ezifana ne-computed tomography (CT) scans, i-magnetic resonance imaging (MRI) scans, okanye i-positron emission tomography (PET) scans, inokwenziwa ukuvavanya ubungakanani besi sifo kunye nokufumanisa ukuba umhlaza usasazeke kwezinye iindawo zesifo. umzimba, njenge-lymph nodes ezikufutshane okanye amalungu akude, njengesisu, i-pelvis, okanye isifuba.
f. Ukubonisana nengcali
Ngokuxhomekeke kwiziphumo zeemvavanyo zokuxilonga, isigulane sinokuthunyelwa kwi-urologist, i-oncologist, okanye ezinye iingcali zokuvavanya ngakumbi kunye nokulawula. Inkqubo yeqela lezinto ezininzi ezibandakanya iingcali zokhathalelo lwempilo zihlala ziqeshwa ukuphuhlisa isicwangciso sonyango esibanzi esilungiselelwe iimfuno zomntu ngamnye zesigulane.
Unyango lomhlaza wamatyhalarha
Unyango lomhlaza wamatyhalarha lubandakanya indlela yokufundisa ngeendlela ezininzi kwaye kuxhomekeke kwizinto ezininzi, kubandakanywa uhlobo kunye nenqanaba lomhlaza, impilo yesigulana iyonke, kunye nezinto esizikhethayo.
a. Utyando (Orchiectomy)
Olona nyango luphambili kumhlaza wamatyhalarha kukususwa ngotyando kwetyhalarha elichaphazelekayo, inkqubo ebizwa ngokuba yi-orchiectomy. Ngexesha le-orchiectomy, i-testicle yonke equlethe i-tumor isuswa ngokusikwa kwi-groin. Kwiimeko ezininzi, linye kuphela isende elichaphazelekayo, kwaye ukususwa kwesende elichaphazelekayo akuchaphazeli ukuzala okanye ukukwazi ukufumana i-erection okanye i-orgasm. Nangona kunjalo, ukuba omabini amasende achaphazelekile, unyango lwehomoni lunokufuneka endaweni ye testosterone.
b. Unyango ngamachiza
Unyango ngamachiza lubandakanya ukusetyenziswa kwamachiza anamandla okubulala iiseli zomhlaza okanye ukunqanda ukukhula nokwahlulahlula. I-Chemotherapy isoloko isetyenziswa emva kotyando ukutshabalalisa naziphi na iiseli zomhlaza eziseleyo okanye ukunyanga umhlaza othe wanwenwa ngaphaya kwetyhalarha. Amachiza athile e-chemotherapy kunye nerejimeni yonyango ixhomekeke kuhlobo kunye nenqanaba lomhlaza. Iziyobisi eziqhelekileyo zechemotherapy ezisetyenziselwa ukunyanga umhlaza wetyhalarha ziquka i-cisplatin, i-etoposide, kunye ne-bleomycin.
c. Unyango ngemitha
Unyango ngemitha lusebenzisa imitha yamandla aphezulu, enje ngeX-reyi okanye iiprotons, ukubulala iiseli zomhlaza okanye ukucutha amathumba. Ingasetyenziselwa kwezinye iimeko ukunyanga i-seminomas, ngakumbi ukuba umhlaza usasazeke kwii-lymph nodes ezikufutshane. Nangona kunjalo, unyango lwemitha aluqhelekanga ukusetyenziswa kunotyando okanye ichemotherapy kunyango lomhlaza wamatyhalarha.
d. Ukutshintshwa kwe-stem cell
Kwezinye iimeko, i-chemotherapy yedosi ephezulu ingasetyenziselwa ukunyanga umhlaza we-testicular. I-chemotherapy enedosi ephezulu ibulala iiseli zomhlaza kodwa iphinda itshabalalise iiseli ezinempilo ezenza igazi kumongo wethambo. Ukubuyisela umsebenzi ophilileyo wamathambo, ukutshintshwa kwe-stem cell kunokwenziwa. Iiseli zesikhondo zinokuqokelelwa egazini lomguli (ufakelo oluzenzekelayo) okanye kumntu onikelayo (ufakelo lwe-allogeneic) zize zifakwe kwigazi lomguli emva konyango lwechemotherapy.
isiphelo
Umhlaza wamatyhalarha yinkxalabo yezempilo echaphazela kakhulu amadoda amancinci kodwa ingenzeka nakweyiphi na iminyaka. Ngaphandle kokunqaba kwawo xa kuthelekiswa neminye imihlaza, umhlaza wamatyhalarha ufuna ukuxilongwa ngokukhawuleza kunye nonyango olufanelekileyo lweziphumo ezizezona zilungileyo. Ngokuhlala enolwazi kwaye ethatha amanyathelo ngempilo yawo, amadoda anokunciphisa ingozi yomhlaza wamatyhalarha kwaye aphucule amathuba awo onyango oluyimpumelelo kunye nokuphila ixesha elide.