Iyini i-Rectovaginal Fistula futhi iphathwa kanjani?

-Delile

• Ziyini izimpawu?
• Yini ebangela lokhu kwenzeke?
• Ngubani osengozini enkulu?
• Kutholakala kanjani?
• Ilashwa kanjani?
• Yiziphi izinkinga ezingadala?
• Ungasiphatha kanjani lesi simo
• Umbono

Ukubuka konke

I-fistula ukuxhumana okungajwayelekile phakathi kwezitho ezimbili. Esimweni se-rectovaginal fistula, ukuxhumana kuphakathi kwe-rectum yowesifazane nowesifazane. Ukuvulwa kuvumela indle nomoya ukuthi kuvuze kusuka emathunjini kuye esithweni sangasese.

Ukulimala ngesikhathi sokubeletha noma ukuhlinzwa kungadala lesi simo.

I-rectovaginal fistula ingahle ingakhululeki, kodwa iyelapheka ngokuhlinzwa.

Ziyini izimpawu?

I-rectovaginal fistula ingadala izimpawu ezahlukahlukene:

• ukudlulisa indle noma igesi kusuka esithweni sakho sangasese
• Inkinga yokulawula ukunyakaza kwamathumbu
• okukhipha iphunga esithweni sakho sangasese
• ukutheleleka okuphindwayo kwesitho sangasese sowesifazane
• ubuhlungu esithweni sangasese noma endaweni ephakathi kwesitho sakho sangasese kanye nendunu (perineum)
• ubuhlungu ngesikhathi socansi

Uma unanoma iyiphi yalezi zimpawu, bheka udokotela wakho.

Yini ebangela lokhu kwenzeke?

Izimbangela ezivame kakhulu ze-rectovaginal fistula zifaka:

• Izinkinga ngesikhathi sokubeletha. Ngesikhathi sokulethwa okude noma okunzima, i-perineum ingadabula, noma udokotela wakho angenza ukusika ku-perineum (episiotomy) ukuletha ingane.
• Isifo samathumbu esivuthayo (IBD). Isifo sikaCrohn kanye ne-ulcerative colitis yizinhlobo ze-IBD. Zibangela ukuvuvukala emkhakheni wokugaya ukudla. Ezimweni ezingavamile, lezi zimo zingakhuphula ubungozi bokuthola i-fistula.
• Umdlavuza noma imisebe ethangeni. Umdlavuza esithweni sakho sangasese, umlomo wesibeletho, i-rectum, isibeletho, noma i-anus ungadala i-rectovaginal fistula. Imisebe yokwelapha lawa mdlavuza nayo ingadala i-fistula.
• Ukuhlinzwa. Ukuhlinzwa esithweni sakho sangasese, i-rectum, i-perineum, noma i-anus kungadala ukulimala noma ukutheleleka okuholela ekuvulekeni okungavamile.

Ezinye izimbangela kungenzeka zifaka:

• ukutheleleka ku-anus noma rectum yakho
• izikhwama ezinegciwane emathunjini akho (diverticulitis)
• indle ibhajwe ku-rectum (impecal impaction) yakho
• izifo ngenxa ye-HIV
• ukuhlukunyezwa ngokocansi

Ngubani osengozini enkulu?

Kungenzeka ukuthi uthole i-rectovaginal fistula uma:

• wawunomsebenzi omude futhi onzima
• i-perineum noma isitho sakho sangasese siklebhukile noma sanqunywa nge-episiotomy ngesikhathi sokubeletha
• unesifo sikaCrohn noma i-ulcerative colitis
• unesifo esifana nethumba noma i-diverticulitis
• uke waba nomdlavuza wesitho sangasese sowesifazane, umlomo wesibeletho, i-rectum, isibeletho, noma i-anus, noma imisebe yokwelapha le mdlavuza
• une-hysterectomy noma okunye ukuhlinzwa endaweni ye-pelvic

Mayelana nabesifazane abathutha abesifazane emhlabeni wonke bathola lesi simo. Kodwa-ke, akuvamile kakhulu emazweni athuthukile njenge-United States. Kuze kube kubantu abanesifo sikaCrohn kuthuthukisa i-rectovaginal fistula.

Kutholakala kanjani?

I-rectovaginal fistula ingaba nzima ukukhuluma ngayo. Noma kunjalo kubalulekile ukutshela udokotela wakho ngezimpawu zakho ukuze uthole ukwelashwa.

Udokotela wakho uzoqala abuze ngezimpawu zakho bese enza ukuhlolwa komzimba. Ngesandla esifakwe igilavu, udokotela uzohlola isitho sakho sangasese, indunu, ne-perineum. Umshini obizwa ngokuthi i-speculum ungafakwa esithweni sakho sangasese ukuze uvuleke ukuze udokotela wakho abone indawo ngokucacile. I-proctoscope ingasiza udokotela wakho ukuthi abone ku-anus naku-rectum yakho.

Izivivinyo udokotela wakho angazisebenzisa ukusiza ukuxilonga i-rectovaginal fistula ifaka:

• I-anorectal noma i-transvaginal ultrasound. Ngesikhathi sokuhlolwa, kufakwa insimbi enjengenduku engquza yakho nasengxenyeni yakho, noma esithweni sakho sangasese. I-ultrasound isebenzisa amaza omsindo ukudala isithombe ngaphakathi kwesikhumba sakho.
• I-Methylene enema. I-tampon ifakwa esithweni sakho sangasese. Ngemuva kwalokho, kufakwa udayi oluhlaza okwesibhakabhaka ku-rectum yakho. Ngemuva kwemizuzu engu-15 kuye kwengu-20, uma i-tampon iba luhlaza okwesibhakabhaka, une-fistula.
• I-Barium enema. Uzothola udayi wokuqhathanisa osiza udokotela wakho ukuthi abone i-fistula ku-X-ray.
• Iskena se-computerised tomography (CT). Lokhu kuhlolwa kusebenzisa ama-X-ray anamandla ukwenza izithombe ezinemininingwane ngaphakathi kwesikhumba sakho.
• Imagnetic resonance imaging (i-MRI). Lokhu kuhlolwa kusebenzisa odonsa abanamandla namagagasi omsakazo ukwenza izithombe ngaphakathi kwesikhumba sakho. Ingakhombisa i-fistula noma ezinye izinkinga ngezitho zakho, njengesimila.

Ilashwa kanjani?

Ukwelashwa okuyinhloko kwe-fistula ukuhlinzwa ukuvala imbobo engavamile. Kodwa-ke, awukwazi ukuhlinzwa uma unesifo noma ukuvuvukala. Izicubu ezizungeze i-fistula zidinga ukwelashwa kuqala.

Udokotela wakho angase asikisele ukuthi ulinde izinyanga ezintathu kuya kweziyisithupha ukuthola ukutheleleka kokutheleleka, nokubona ukuthi i-fistula iyazivalela yini. Uzothola ama-antibiotic ukwelapha ukutheleleka noma i-infliximab (Remicade) ukwehlisa ukuvuvukala uma unesifo sikaCrohn.

Ukuhlinzwa kwe-rectovaginal fistula kungenziwa ngesisu sakho, isitho sakho sangasese, noma i-perineum. Ngesikhathi sokuhlinzwa, udokotela wakho uzothatha ucezu lwesicubu kusuka kwenye indawo emzimbeni wakho bese enza i-flap noma ipulagi ukuvala ukuvulwa. Udokotela ohlinzayo uzophinde alungise imisipha ye-anal sphincter uma ilimele.

Abanye besifazane bazodinga i-colostomy. Lokhu kuhlinzwa kudala ukuvuleka okubizwa nge-stoma odongeni lwesisu sakho. Ukuphela kwamathumbu akho amakhulu kufakwa embobeni. Isikhwama siqoqa udoti kuze kuphole i-fistula.

Ungakwazi ukuya ekhaya ngosuku olufanayo nokuhlinzwa kwakho. Kwezinye izinhlobo zokuhlinzwa, kuzodingeka ulale esibhedlela.

Izingozi ezingenzeka kusukela ekuhlinzeni zifaka:

• ukopha
• ukutheleleka
• ukulimala kwesinye, ureters, noma amathumbu
• ihlule legazi emilenzeni noma emaphashini
• ukuvinjelwa emathunjini
• izibazi

Yiziphi izinkinga ezingadala?

I-Rectovaginal fistula ingathinta impilo yakho yezocansi. Ezinye izinkinga zifaka:

• inkathazo yokulawula ukudlula kwesitulo (ukungabi namandla)
• ukuphindaphindwa komgudu wokuchama noma ukutheleleka kwesitho sangasese sowesifazane
• ukuvuvukala kwesitho sakho sangasese noma i-perineum
• isilonda esigcwele ubomvu (ithumba) ku-fistula
• enye i-fistula ngemuva kwelashwa eyokuqala

Ungasiphatha kanjani lesi simo

Ngenkathi ulinde ukuhlinzwa, landela lawa macebiso ukuze uzisize uzizwe ungcono:

• Thatha ama-antibiotic noma eminye imithi udokotela wakho akunikeze yona.
• Gcina indawo ihlanzekile. Geza isitho sakho sangasese ngobumnene ngamanzi afudumele uma udlula indle noma iphunga elibi. Sebenzisa kuphela insipho emnene, engenamanzi. Pat indawo eyomile.
• Sebenzisa ukusula okungenasenti esikhundleni sephepha langasese lapho usebenzisa indlu yangasese.
• Faka i-talcum powder noma ukhilimu wokuvimbela umswakama ukuvimbela ukucasuka esithweni sakho sangasese nakunxande.
• Gqoka izingubo ezivulekile, eziphefumulayo ezenziwe ngokotini noma ezinye izindwangu zemvelo.
• Uma uvuza indle, gqoka izingubo zangaphansi ezilahlwayo noma inabukeni yabantu abadala ukuze ugcine indle isikhumba sakho.

Umbono

Kwesinye isikhathi i-rectovaginal fistula ivala yodwa. Isikhathi esiningi, ukuhlinzwa kuyadingeka ukulungisa inkinga.

Amathuba okuphumelela kokuhlinzwa axhomeke kuhlobo luni lwenqubo onayo. Ukuhlinzwa kwesisu kunenani eliphezulu kakhulu lempumelelo, e. Ukuhlinzwa ngokusebenzisa isitho sangasese sowesifazane noma i-rectum cishe kunenani lempumelelo. Uma ukuhlinzwa kokuqala kungasebenzi, uzodinga enye inqubo.