Yintoni iRectovaginal Fistula kwaye inyangwa njani?

Umxholo

• Ziintoni iimpawu?
• Yintoni ebangela ukuba oku kwenzeke?
• Ngubani osemngciphekweni omkhulu?
• Kufunyaniswa njani?
• Inyangwa njani?
• Zeziphi iingxaki ezinokubangela?
• Ungayilawula njani le meko
• Imbonakalo

Ushwankathelo

I-fistula liqhagamshelo elingaqhelekanga phakathi kwamalungu amabini. Kwimeko yesifo se-rectovaginal fistula, unxibelelwano luphakathi kwethanga lomfazi kunye nelungu lobufazi. Ukuvulwa kuvumela ilindle kunye negesi ukuba ivuze ukusuka emathunjini ukuya kwilungu lobufazi.

Ukonzakala ngexesha lokubeleka okanye lotyando kunokubangela le meko.

I-rectovaginal fistula ayinakukhathazeka, kodwa iyanyangeka ngotyando.

Ziintoni iimpawu?

I-Rectovaginal fistula inokubangela iimpawu ezahlukeneyo:

• ukuhambisa isitulo okanye irhasi kwilungu lakho lobufazi
• ingxaki yokulawula ukuhamba kwamathumbu
• Ukukhupha okunukayo kwilungu lakho lobufazi
• usulelo oluphindaphindiweyo lobufazi
• iintlungu kwilungu lobufazi okanye kwindawo ephakathi kwelungu lakho lobufazi kunye ne-anus (perineum)
• intlungu ngexesha lokwabelana ngesondo

Ukuba unayo nayiphi na le mpawu, jonga ugqirha wakho.

Yintoni ebangela ukuba oku kwenzeke?

Oonobangela abaqhelekileyo besifo se-rectovaginal fistula kubandakanya:

• Iingxaki ngexesha lokubeleka. Ngexesha lokuhanjiswa okude okanye okunzima, i-perineum inokukrazula, okanye ugqirha wakho unokwenza ukusika kwi-perineum (episiotomy) ukuhambisa umntwana.
• Isifo sesisu esivuthayo (IBD). Isifo sikaCrohn kunye ne-ulcerative colitis ziintlobo ze-IBD. Zibangela ukudumba kwindawo yokugaya ukutya. Kwiimeko ezinqabileyo, le miqathango inokunyusa umngcipheko wokuphuhlisa i-fistula.
• Umhlaza okanye imitha kwimithambo yesinqe. Umhlaza kwilungu lakho lobufazi, umlomo wesibeleko, i-rectum, isibeleko, okanye i-anus kunokubangela i-rectovaginal fistula. Imitha yokunyanga le mihlaza inokudala i-fistula.
• Ugqirha. Ukwenza utyando kwilungu lobufazi, i-rectum, i-perineum, okanye i-anus kunokubangela ukonzakala okanye usulelo olukhokelela kuvulo olungaqhelekanga.

Ezinye izizathu ezinokubakho zibandakanya:

• usulelo kwi-anus okanye kwi-rectum yakho
• Iipakethi ezosulelekileyo emathunjini akho (diverticulitis)
• I-stool ibambelele kwi-rectum yakho (impecal impaction)
• usulelo ngenxa ye-HIV
• Ukuhlaselwa ngokwesondo

Ngubani osemngciphekweni omkhulu?

Kungenzeka ukuba ufumane i-rectovaginal fistula ukuba:

• wabulaleka ixesha elide unzima
• i-perineum yakho okanye isini sakho sikrazukile okanye sasikwa nge-episiotomy ngexesha lokubeleka
• unesifo sikaCrohn okanye i-ulcerative colitis
• unesifo esifana nethumba okanye i-diverticulitis
• Unomhlaza welungu lobufazi, umlomo wesibeleko, i-rectum, isibeleko, okanye i-anus, okanye i-radiation ukunyanga le mihlaza
• ubukade une-hysterectomy okanye olunye utyando kwindawo ye-pelvic

Malunga nabasetyhini abahambisa ubufazi kwilizwe liphela bafumana le meko. Nangona kunjalo, kuncinci kakhulu kumazwe athuthukileyo afana ne-United States. Ukuza kuthi ga kubantu abanesifo sikaCrohn baphuhlise i-rectovaginal fistula.

Kufunyaniswa njani?

I-Rectovaginal fistula kunokuba nzima ukuthetha ngayo. Nangona kunjalo kubalulekile ukuxelela ugqirha wakho malunga neempawu zakho ukuze ufumane unyango.

Ugqirha wakho uya kuqala abuze malunga neempawu zakho kwaye enze uvavanyo lomzimba. Ngesandla esifakwe iiglavu, ugqirha uya kujonga kwilungu lakho lobufazi, umva, kunye ne-perineum. Isixhobo esibizwa ngokuba yi-speculum sinokufakwa kwilungu lobufazi ukuze uyivule ukuze ugqirha wakho abone indawo ngokucacileyo. Iproctoscope inokunceda ugqirha wakho ukuba abone kwi-anus kunye ne-rectum yakho.

Uvavanyo ugqirha anokulisebenzisa ukunceda ukufumanisa ukuba i-rectovaginal fistula ibandakanya:

• Anorectal okanye transvaginal ultrasound. Ngexesha lovavanyo, isixhobo esifana ne-wand sifakwa kwi-anus yakho kunye ne-rectum, okanye kwilungu lakho lobufazi. I-ultrasound isebenzisa amaza esandi ukwenza umfanekiso ngaphakathi kwesinqe sakho.
• Imethylene enema. Itampu ifakwe kwilungu lakho lobufazi. Emva koko, idayi eluhlaza okwesibhakabhaka ifakwe kwi-rectum yakho. Emva kwemizuzu eli-15 ukuya kwengama-20, ukuba itampon iba luhlaza okwesibhakabhaka, une-fistula.
• I-enema yeBarium. Uya kufumana idayi eyahlukileyo enceda ugqirha wakho abone i-fistula kwi-X-ray.
• Iskena sekhompyuter seTomography (CT). Olu vavanyo lusebenzisa i-X-ray enamandla ukwenza imifanekiso eneenkcukacha ngaphakathi kwethambo lakho.
• Imagnetic resonance imaging (MRI). Olu vavanyo lusebenzisa oomazibuthe abomeleleyo kunye namaza erediyo ukwenza imifanekiso ngaphakathi kwesinqe sakho. Ingabonisa i-fistula okanye ezinye iingxaki kumalungu akho, anjenge-tumor.

Inyangwa njani?

Olona nyango luphambili lwefistula lutyando lokuvala ukuvulwa okungaqhelekanga. Nangona kunjalo, awunakho ukwenza utyando ukuba unosulelo okanye ukudumba. Izicubu ezijikeleze i-fistula kufuneka ziphilise kuqala.

Ugqirha wakho unokucebisa ukuba ulinde iinyanga ezintathu ukuya kwezintandathu ukuze usulelo luphole, kwaye ubone ukuba ngaba i-fistula iyazivalela na. Uya kufumana ii-antibiotics ukunyanga usulelo okanye i-infliximab (Remicade) ukwehlisa ukudumba ukuba unesifo sikaCrohn.

Uqhaqho lwe-Rectovaginal fistula lunokwenziwa kwisisu sakho, kwilungu lobufazi, okanye kwi-perineum. Ngexesha lotyando, ugqirha wakho uya kuthatha isiqwenga seethishu kwenye indawo emzimbeni wakho kwaye enze iflap okanye iplagi ukuvala ukuvulwa. Ugqirha uya kuphinda alungise izihlunu ze-sphincter zangasese ukuba zonakalisiwe.

Abanye abafazi baya kufuna i-colostomy. Olu tyando lwenza ukuvulwa okubizwa ngokuba yi-stoma eludongeni lwesisu sakho. Ukuphela kwamathumbu akho amakhulu kufakwa kwindawo yokuvula. Ingxowa iqokelela inkunkuma ide iphole i-fistula.

Unokwazi ukuya ekhaya ngosuku olufanayo kunye nophando lwakho. Kwezinye iintlobo zoqhaqho, kuya kufuneka ulale esibhedlele.

Umngcipheko onokubakho kuqhaqho kubandakanya:

• ukopha
• usulelo
• umonakalo kwisinyi, ureters, okanye emathunjini
• ihlwili legazi emilenzeni okanye emiphungeni
• ukuvaleka kwamathumbu
• izilonda

Zeziphi iingxaki ezinokubangela?

I-Rectovaginal fistula inokuchaphazela ubomi bakho ngokwesondo. Ezinye iingxaki zibandakanya:

• unengxaki yokulawula ukuhamba kwesitulo (ukungasebenzi kakuhle)
• ukuphindaphindeka komchamo okanye usulelo lobufazi
• ukudumba kwelungu lakho lobufazi okanye i-perineum
• isilonda esigcwele ubofu (ithumba) kwi-fistula
• enye i-fistula emva kokunyangwa kokuqala

Ungayilawula njani le meko

Ngelixa ulinde ukuba utyando, landela ezi ngcebiso ukuze uzincede uzive ungcono:

• Thatha i-antibiotics okanye amanye amayeza ugqirha ugqirha.
• Gcina indawo icocekile. Hlamba ubufazi bakho ngobunono ngamanzi afudumeleyo xa upasa ilindle okanye into enuka kakubi. Sebenzisa isepha ethambileyo kuphela. Pat indawo eyomileyo.
• Sebenzisa izesuli ezingenasenti endaweni yephepha langasese xa usebenzisa igumbi lokuhlambela.
• Faka i-talcum powder okanye ukhilimu othintela ukufuma ukuthintela ukucaphuka kwilungu lakho lobufazi kunye ne-rectum.
• Nxiba iimpahla ezikhululekileyo neziphefumlayo ezenziwe ngomqhaphu okanye ngamanye amalaphu endalo.
• Ukuba uvuza ilindle, nxiba iimpahla zangaphantsi ezilahlwayo okanye ilweyitha elidala ukugcina ilindle lingekho kulusu lwakho.

Imbonakalo

Ngamanye amaxesha i-rectovaginal fistula iyazivalela. Uninzi lwexesha, utyando luyafuneka ukulungisa ingxaki.

Amathuba okuphumelela kotyando axhomekeke kuhlobo luni lwenkqubo onayo. Utyando lwesisu lunelona zinga liphezulu lokuphumelela, e. Ugqirha olwenziwa kwilungu lobufazi okanye kwi-rectum malunga nenqanaba lempumelelo. Ukuba utyando lokuqala alusebenzi, uzakufuna enye inkqubo.