Rectovaginal Fistula

Ọnya rectovaginal bụ njikọ na ekwesịghị ịdị n'etiti akụkụ ala nke eriri afọ dị ukwuu — rectum ma ọ bụ anus — na ọnya. Ihe dị na afọ nwere ike iwepụta site na ọnya ahụ, na-eme ka gas ma ọ bụ stool gbapụta site na ọnya.

Ọnya rectovaginal nwere ike ịbụ n'ihi:

• Mmerụ ahụ n'oge ịmụ nwa.
• Ọrịa Crohn ma ọ bụ ọrịa afọ ndị ọzọ na-akpata mbufụt.
• Ịgwọ ọrịa site na radiation ma ọ bụ kansa na mpaghara pelvic.
• Nsogbu mgbe emechara ọrụ n'ebe pelvic.
• Nsogbu site na diverticulitis, ọrịa nke obere akpa na-apụta na eriri afọ.

Ọrịa ahụ nwere ike ime ka gas na stool gbapụta site na ọnya. Nke a nwere ike ibute nsogbu uche na ahụ erughị ala, nke nwere ike imetụta onyinye onwe gị na mmekọrịta.

Kparịta ụka na onye na-elekọta ahụike gị ma ọ bụrụ na ị nwere ihe ịrịba ama nke ọnya rectovaginal, ọbụna ma ọ bụrụ na ọ na-eme ihere. Ụfọdụ ọnya rectovaginal nwere ike imechi onwe ha, mana ọtụtụ chọrọ ọrụ eji emezi ha.

Ịgbapụ gas ma ọ bụ mmamịrị site na ụzọ ime bụ ihe mgbaàmà kachasị emetụta mmadụ nke ọnya rectovaginal. Dabere na nha na ebe ọnya ahụ dị, ị nwere ike inwe ihe mgbaàmà dị ntakịrị. Ma ọ bụ ị nwere ike inwe nsogbu dị ukwuu na mmamịrị na gas na-asọpụta na idebe ebe ahụ ọcha. Gaa hụ onye ọgwụgwọ ahụike gị ma ọ bụrụ na ị nwere ihe mgbaàmà ọ bụla nke ọnya rectovaginal.

Gaa hụ ọkachamara ahụike gị ma ọ bụrụ na ị nwere ihe ịrịba ama ọ bụla nke fistula rectovaginal.

A rectovaginal fistula nwere ike ịme site na:

• Mmerụ ahụ n'oge ịmụ nwa. Mmerụ ahụ metụtara ịmụ nwa bụ ihe kacha akpata rectovaginal fistulas. Mmerụ ahụ gụnyere igbawa n'ime perineum — akpụkpọ ahụ dị n'etiti ọnya na azụ — nke na-aga n'ime afọ ma ọ bụ ọrịa. Fistulas ndị a kpatara site na mmerụ ahụ n'oge ịmụ nwa nwere ike ịgụnye mmerụ ahụ na anal sphincter — mgbanaka nke anụ ahụ dị na njedebe nke rectum nke na-enyere aka ijide stool.
• Ọrịa afọ na-akpata mbufụt. Ihe kacha abụọ na-akpata rectovaginal fistulas bụ Crohn's disease na, obere mgbe, ulcerative colitis. Ndị ọrịa afọ na-akpata mbufụt a na-akpata mbufụt na iwe nke anụ ahụ na-agbanye n'ime akụkụ digestive. Ọtụtụ ndị nwere Crohn's disease adịghị emepụta rectovaginal fistula, mana inwe Crohn's disease na-eme ka ọ dịkwuo elu.
• Ọrịa kansa ma ọ bụ ọgwụgwọ mgbawa na mpaghara pelvic. Ọrịa kansa dị na rectum gị, cervix, ọnya, uterus ma ọ bụ anal canal nwere ike ime ka rectovaginal fistula pụta. Ọzọkwa, ọgwụgwọ mgbawa maka ọrịa kansa dị na mpaghara ndị a nwere ike itinye gị n'ihe ize ndụ. A fistula kpatara site na mgbawa nwere ike ime mgbe ọ bụla mgbe ọgwụgwọ mgbawa gasịrị, mana ọ na-emekarị n'ime afọ abụọ mbụ.
• Ọrụ ọgwụgwọ metụtara ọnya, perineum, rectum ma ọ bụ anus. N'ọnọdụ dị oke mkpa, ọrụ ọgwụgwọ gara aga na mpaghara pelvic gị dị ala, dị ka iwepụ Bartholin's gland na-efe efe, nwere ike ime ka fistula pụta. Bartholin's glands dị na akụkụ ọ bụla nke ọnụ ọnya ma na-enyere aka ijide ọnya mmiri. Fistula nwere ike ịme site na mmerụ ahụ n'oge ọrụ ọgwụgwọ ma ọ bụ mgbawa ma ọ bụ ọrịa na-eme mgbe e mesịrị.
• Nsogbu site na diverticulitis. Ọrịa nke obere akpa na-agbawa n'ime akụkụ digestive gị, nke a na-akpọ diverticulitis, nwere ike ime ka rectum ma ọ bụ afọ dị ukwuu kpọọrọ ọnya ma nwee ike ibute fistula.
• Ihe ndị ọzọ na-akpata ya. Ọ dịghị mgbe, rectovaginal fistula nwere ike ịme mgbe ọrịa na-efe efe na akpụkpọ ahụ dị gburugburu anus ma ọ bụ ọnya.

A na-ahụghị ihe kpatara ọnya n'etiti akụkụ azụ na akụkụ nwanyị.

Nsogbu ndị a pụrụ ịbụ n'ihi ọnya rectovaginal gụnyere:\n\n- Ịgbapụ stool na-achịkwaghị, nke a na-akpọ fecal incontinence.\n- nsogbu ịdị ọcha perineum.\n- ọrịa nje na-eme ugboro ugboro na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme 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na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme na-eme

Enweghi usoro ọ bụla ịchọrọ ime iji gbochie ọnya rectovaginal.

Ịchọpụta ọnya fistula dị n'etiti akụkụ azụ na ọnụ ụmụ nwanyị, dọkịta gị ga-akparịta ụka gị banyere ihe mgbaàmà gị ma mee nyocha ahụike. Dọkịta gị nwere ike ikwubi ule ụfọdụ dabere na mkpa gị.

Dọkịta gị na-eme nyocha ahụike ịchọta ọnya fistula dị n'etiti akụkụ azụ na ọnụ ụmụ nwanyị ma lelee ma ọ bụrụ na enwere ọrịa kansa, ọrịa nje ma ọ bụ mgbawa. Nyocha ahụike na-agụnye ile anya n'ọnụ ụmụ nwanyị, azụ, na mpaghara dị n'etiti ha, nke a na-akpọ perineum, na aka uwe. Ngwaọrụ e mere maka itinye site na fistula nwere ike iji chọta ọnya fistula.

Ọ gwụghị na ọnya fistula dị ala n'ọnụ ụmụ nwanyị ma dị mfe ịhụ, dọkịta gị nwere ike iji speculum ijide mgbidi ahụ ka ọ hụ n'ime ọnụ ụmụ nwanyị. Ngwaọrụ yiri speculum, nke a na-akpọ proctoscope, nwere ike itinye n'azụ na akụkụ azụ.

N'ọnọdụ dị oke egwu nke dọkịta gị na-eche na ọnya fistula nwere ike ịbụ n'ihi ọrịa kansa, dọkịta ahụ nwere ike were obere akụkụ anụ ahụ n'oge nyocha ahụike maka nyocha. A na-akpọ nke a biopsy. A na-eziga akụkụ anụ ahụ ahụ na ụlọ nyocha ka e lelee sel ndị ahụ.

Ọtụtụ mgbe, a na-ahụ ọnya fistula dị n'etiti akụkụ azụ na ọnụ ụmụ nwanyị ngwa ngwa n'oge nyocha pelvic. Ọ bụrụ na aghọtaghị ọnya fistula n'oge nyocha ahụike, ị nwere ike ịchọ ule. Ule ndị a nwere ike inyere ndị otu ahụike gị aka ịchọta ma lelee ọnya fistula dị n'etiti akụkụ azụ na ọnụ ụmụ nwanyị ma nwee ike inyere gị aka ịhazi maka ọgwụgwọ, ọ bụrụ na ọ dị mkpa.

• CT scan. CT scan nke afọ gị na pelvic na-enye nkọwa karịa X-ray nkịtị. CT scan nwere ike inyere aka ịchọta ọnya fistula ma chọpụta ihe kpatara ya.
• MRI. Ule a na-emepụta onyinyo nke anụ ahụ dị nro n'ahụ gị. MRI nwere ike egosi ebe ọnya fistula dị, ma ọ bụrụ na akụkụ pelvic ndị ọzọ metụtara ma ọ bụ ma ị nwere ọrịa kansa.
• Ule ndị ọzọ. Ọ bụrụ na dọkịta gị na-eche na ị nwere ọrịa afọ na-agbawa agbawa, ị nwere ike ịme colonoscopy ile anya n'ime afọ gị. N'oge usoro ahụ, a nwere ike iweghachite obere akụkụ anụ ahụ maka nyocha ụlọ nyocha. Ihe nlereanya nwere ike inyere aka ịmara ma ị nwere ọrịa Crohn ma ọ bụ ọnọdụ afọ na-agbawa agbawa ndị ọzọ.
• Nyocha n'okpuru anesthesia. Ọ bụrụ na ule ndị ọzọ aghọtaghị ọnya fistula, onye ọgwụgwọ gị nwere ike ịchọ inyocha gị na ụlọ ọgwụ. Nke a na-enye ohere ile anya nke ọma n'ime azụ na akụkụ azụ ma nwee ike inyere aka ịchọta ọnya fistula ma nyere aka ịhazi ọgwụgwọ.