Ese imyanya y’umubiri yitwa Rectovaginal Fistula ni iki? Ibimenyetso, Intandaro n’Ubuvuzi

Rectovaginal fistula ni udukari tugabanya uruhinja rw’umubiri hagati y’umwanya w’inyuma (rectum) n’umwanya w’igitsina (vagina), bikaba byatuma umwanda n’umwuka uvuye mu mara ugaragara mu gitsina. Uyu mwanya ugomba kuba udafite ikibazo, kandi iyo ubayeho, bishobora gutera ikibazo gikomeye kandi ukumva uri wenyine. Ntago uri wenyine muri iki kibazo, kandi hari ubuvuzi burambuye bushobora kugufasha gusubiza ubuzima bwawe mu buryo busanzwe.

Ese imyanya y’umubiri yitwa rectovaginal fistula ni iki?

Rectovaginal fistula ihanga umwanya usa n’umuhanda hagati y’umwanya w’inyuma (igice cya nyuma cy’amara manini) n’umwanya w’igitsina. Uyu mwanya utuma ibintu biri mu mara bijya mu gitsina aho kujya mu kibuno nk’uko bisanzwe.

Ubunini bw’iyi myanya y’umubiri butandukanye cyane. Imwe iba mito cyane, izindi zikaba nini kandi zigoye. Aho iherereye ku rukuta rw’umubiri hagati y’umwanya w’inyuma n’umwanya w’igitsina na byo bitandukanye, bikagira ingaruka ku bimenyetso n’uburyo bwo kuvura.

Iki kibazo kigira ingaruka ku buzima bwawe bwa buri munsi, bikagira ingaruka kuri byose kuva ku isuku kugeza ku mibanire y’abakundana. Gusobanukirwa ibibaho mu mubiri wawe ni intambwe ya mbere yo kubona ubufasha ukeneye.

Ese ni ibihe bimenyetso bya rectovaginal fistula?

Ikimenyetso gikomeye ni umwanda cyangwa umwuka uvuye mu mara ugaragara mu gitsina aho kuva mu kibuno. Ibi bishobora kuba bitunguranye kandi bikaba bibabaza, cyane cyane iyo ugerageza gukora ibikorwa bya buri munsi.

Dore ibimenyetso nyamukuru ushobora kugira:

• Umwanda ugaragara mu gitsina
• Umwuka uvuye mu mara ugaragara mu gitsina
• Ibisohora mu gitsina bifite impumuro mbi
• Indwara zikunze kugaragara mu gitsina cyangwa mu nzira y’umushishi
• Kubabara igihe ugiye ku musarani
• Kubabara cyangwa gutwika hafi y’umwanya w’igitsina
• Kubabara igihe ukora imibonano mpuzabitsina
• Kubabara mu nda cyangwa kutagira amahoro

Bamwe mu bagore bagira n’ububabare ku ruhu rwo hafi y’umwanya w’igitsina bitewe no guhura n’umwanda. Ingaruka zo mu mutwe zishobora kuba zikomeye nk’ibimenyetso by’umubiri, bikunze gutera impungenge ku bijyanye n’imibereho ya sosiyete cyangwa imibanire y’abakundana.

Ese ni izihe ngero za rectovaginal fistula?

Abaganga basobanura rectovaginal fistula hashingiwe aho iherereye n’uburyo igoye. Gusobanukirwa ubwoko bwawe bw’iyi myanya y’umubiri bigufasha kumenya uburyo bwiza bwo kuvura.

Ubwoko nyamukuru burimo:

• Rectovaginal fistula yo hasi: Ihera hafi y’umwanya w’igitsina, ikaba ishobora kuvurwa byoroshye
• Rectovaginal fistula yo hejuru: Ihera hejuru mu mwanya w’igitsina, ishobora gusaba ubuvuzi bugoye
• Fistula yoroshye: Umwanya muto, woroshye, ufite imyanya y’umubiri ikingira neza
• Fistula igoye: Umwanya munini, imyanya myinshi, cyangwa ikikijwe n’imiterere y’umubiri yangiritse cyangwa yanduye

Muganga wawe azamenya ubwoko ufite binyuze mu isuzuma n’ibizamini by’amashusho. Ubu bwoko bugira uruhare mu buryo bwo kubaga no mu gihe cyo gukira.

Ese ni iki gitera rectovaginal fistula?

Ibintu byinshi bishobora gutera rectovaginal fistula. Intandaro ikunze kugaragara ni ingaruka zo kubyara, ariko izindi ndwara n’ubuvuzi bishobora kandi gutera iyi myanya y’umubiri.

Intandaro nyamukuru zirimo:

• Imvune zo kubyara: Kwangirizwa bikomeye igihe ubyara, cyane cyane imvune zikomeye zigeze mu mwanya w’inyuma
• Indwara z’amara: Crohn’s disease ishobora gutera ububabare butuma imyanya y’umubiri ihangana
• Ingaruka zo kubagwa: Ingaruka zo kuvura imvune zo kubyara, kuvura indwara z’amara, cyangwa ubundi buvuzi mu gice cy’ibice by’imbere
• Ubuvuzi bw’imirasire: Ubuvuzi bwa kanseri mu gice cy’ibice by’imbere bishobora kugabanya imbaraga z’imyanya y’umubiri
• Amazi: Amazi akomeye hagati y’umwanya w’inyuma n’umwanya w’igitsina
• Kanseri: Udukoko mu mwanya w’inyuma, mu gitsina, cyangwa mu kiziba cy’igitsina bishobora gutera imyanya y’umubiri hagati y’imiterere y’umubiri
• Imvune mu gice cy’ibice by’imbere: Impanuka cyangwa imvune zikomeye mu gice cy’ibice by’imbere

Mu bihe bitoroshye, bamwe mu bagore bavukana rectovaginal fistula bitewe n’uburyo butunganye mu gihe cyo gutwita. Rimwe na rimwe intandaro nyayo iba itaramenyekana, ibyo bishobora gutera agahinda ariko ntibigira ingaruka ku buryo bwo kuvura.

Ni ryari ukwiye kujya kwa muganga kubera rectovaginal fistula?

Ukwiye guhamagara muganga wawe ako kanya iyo ubona umwanda cyangwa umwuka uvuye mu mara ugaragara mu gitsina. Iki kimenyetso gikenera isuzuma rya muganga, kuko ntabwo ari ikintu kizakira ukwacyo.

Shaka ubufasha bw’abaganga niba ufite ibimenyetso by’ibi bikurikira:

• Umwanda ugaragara mu gitsina
• Ibisohora mu gitsina bifite impumuro mbi
• Indwara zikunze kugaragara mu gitsina cyangwa mu nzira y’umushishi
• Kubabara cyane igihe ugiye ku musarani cyangwa ukora imibonano mpuzabitsina
• Ibimenyetso by’ubwandu nka fiive, guhinda umuriro, cyangwa kubabara mu gice cy’ibice by’imbere

Ubuvuzi bwihuse bukunze gutera umusaruro mwiza kandi bushobora gukumira ingaruka. Ntukagire ipfunwe ryo kuvugana n’umuganga wawe kuri ibi bimenyetso – bahuguwe mu gufasha muri ibi bibazo bafite ubumenyi n’ubwenge.

Ese ni ibihe bintu bishobora kongera ibyago byo kurwara rectovaginal fistula?

Ibintu bimwe bishobora kongera ibyago byo kurwara rectovaginal fistula. Gusobanukirwa ibi bintu bigufasha wowe n’abaganga bawe gufata ibyemezo byiza bijyanye no kwirinda no kuvura.

Ibintu byongera ibyago birimo:

• Kubyara bigoye: Kubyara igihe kirekire, gukoresha ibikoresho byo gufasha kubyara, cyangwa umwana munini
• Kubagwa mu gice cy’ibice by’imbere: Amateka y’ubuvuzi mu kibuno cyangwa mu gitsina
• Indwara z’amara: Cyane cyane Crohn’s disease ikora ku mwanya w’inyuma
• Ubuvuzi bw’imirasire: Ubuvuzi bwa kanseri bugamije gice cy’ibice by’imbere
• Imyaka myinshi igihe ubyara: Kuba ufite imyaka irenga 35 igihe ubyara
• Kugira impatwe: Gukoresha imbaraga igihe kirekire igihe ugiye ku musarani
• Imirire mibi: Ibintu bigira ingaruka ku gukira kw’imyanya y’umubiri
• Itabi: Bigabanya amaraso n’ubukemurampaka bw’imyanya y’umubiri

Kugira ibyago ntibisobanura ko uzahita urwara iyi ndwara. Abagore benshi bafite ibi bintu ntibarwara iyi ndwara, abandi badafite ibyago byihariye barayirwara.

Ese ni izihe ngaruka zishoboka za rectovaginal fistula?

Niba itavuwe, rectovaginal fistula ishobora gutera ingaruka nyinshi zigira ingaruka ku buzima bwawe n’imibereho yawe. Gusobanukirwa ibi bibazo bigaragaza impamvu kuvurwa ari ingenzi.

Ingaruka zishoboka zirimo:

• Indwara zikunze kugaragara: Indwara zikunze kugaragara mu gitsina, mu nzira y’umushishi, cyangwa mu gice cy’ibice by’imbere
• Kwangirizwa kw’uruhu: Kubabara no kubabara hafi y’umwanya w’igitsina n’ikibuno
• Kwikurura mu bandi: Kugorana mu gukora ibikorwa bisanzwe bitewe n’impumuro mbi n’umwanda
• Ibibazo by’imibonano mpuzabitsina: Kubabara igihe ukora imibonano mpuzabitsina n’ibibazo mu mibanire
• Agahinda: Depresiyo, impungenge, no kubura icyizere
• Kubura ubusugire bw’umubiri: Mu bihe bitoroshye, iyo imyanya y’umubiri ari minini bikaba byateje igihombo kinini cy’amazi

Inkuru nziza ni uko, ukoresheje ubuvuzi bukwiye, ingaruka nyinshi zishobora kwirindwa cyangwa gukira. Ikipe y’abaganga bawe izakorana nawe kugira ngo bakemure ibibazo by’umubiri n’ibyo mu mutwe.

Ese rectovaginal fistula imenyekanwa gute?

Muganga wawe azatangira aganira nawe ku bimenyetso byawe n’amateka yawe y’ubuzima. Azakubaza ibyabaye igihe ubyara, ubuvuzi bwakozwe mbere, n’izindi ndwara kugira ngo asobanukirwe intandaro zishoboka.

Uburyo bwo kuvura busanzwe burimo isuzuma ry’umubiri aho muganga wawe azasuzumira umwanya w’igitsina n’umwanya w’inyuma. Iki isuzuma rishobora kuba ritari ryiza, ariko ni ngombwa kugira ngo hamenyekane aho iyi myanya y’umubiri iherereye n’ubunini bwayo.

Ibizamini byongeyeho bishobora kuba birimo:

• Fistulogram: X-ray ifite amabara yerekana aho iyi myanya y’umubiri iherereye
• CT scan cyangwa MRI: Amashusho arambuye yo kureba imyanya y’umubiri iikikije no gukumira izindi ndwara
• Colonoscopy: Isuzuma ry’amara manini kugira ngo harebwe Crohn’s disease
• Anorectal manometry: Ibizamini byo kupima uko imyanya y’umubiri ikora
• Endorectal ultrasound: Amashusho y’amajwi yo gusuzuma imikaya y’umwanya w’inyuma

Muganga wawe ashobora kandi gukora ikizamini cya methylene blue, aho amabara y’ubururu ashyirwa mu mwanya w’inyuma kugira ngo arebe niba agaragara mu gitsina. Ibi bizamini bifasha kumenya neza uko iyi ndwara imeze no gutegura uburyo bwo kuvura.

Ese ni ubuhe buvuzi bwa rectovaginal fistula?

Ubuvuzi biterwa n’ibintu byinshi birimo ubunini n’aho iyi myanya y’umubiri iherereye, intandaro yayo, n’ubuzima bwawe muri rusange. Muganga wawe azategura gahunda y’ubuvuzi ikubereye kugira ngo ugire amahirwe yo gukira.

Imikaya mito kandi yoroshye rimwe na rimwe ikira ukwayo ikoresheje uburyo bworoshye. Ubu buryo bushobora kuba burimo guhindura imirire, imiti igabanya umwanda, n’isuku nziza. Muganga wawe azakurikirana uko ugendera hafi muri icyo gihe.

Kubaga bikunze kuba ngombwa ku mikaya minini cyangwa igoye. Uburyo nyamukuru bwo kubaga burimo:

• Fistulotomy: Kugura no gusukura umwanya w’iyi myanya y’umubiri
• Advancement flap repair: Gukoresha imyanya y’umubiri ikingira neza kugira ngo ifunge umwanya
• Muscle interposition: Gushyira imikaya hagati y’umwanya w’inyuma n’umwanya w’igitsina
• Temporary colostomy: Kugira ngo umwanda utarebe muri uwo mwanya kugira ngo ukire

Ku mikaya iterwa na Crohn’s disease, muganga wawe ashobora kwandika imiti igabanya ububabare mbere yo kugerageza kubaga. Ubu buryo bukunze kongera amahirwe yo gukira.

Ese wakwitwara ute mu rugo?

Ugiye gutegereza ubuvuzi cyangwa mu gihe cyo gukira, hari uburyo bwo kwitwara mu rugo bushobora kugufasha guhangana n’ibimenyetso no kugumana amahoro. Ubu buryo bukorana n’ubuvuzi bwa muganga, si ukubusimbuza.

Uburyo bwo kwitwara mu rugo burimo:

• Isuku nziza: Kwoza neza hakoreshejwe amazi ashyushye nyuma yo kujya ku musarani
• Amavuta yo kurinda uruhu: Gukoresha zinc oxide cyangwa petroleum jelly kugira ngo uruhu rudakomeretswa
• Guhindura imirire: Kurya ibiryo bidatera impatwe kugira ngo umwanda utagire umunaniro
• Kunywamo amazi ahagije: Kunywa amazi menshi kugira ngo umwanda ube woroshye
• Imwambaro iboneye: Kwambara imyenda idafunze, ihuha, no guhindura imyenda yawe kenshi
• Sitz baths: Koga mu mazi ashyushye iminota 10-15 kugira ngo uruhu rukire

Tegereza kwandika ibimenyetso byawe kugira ngo umenye ibyabaye n’ibintu byabiteye. Aya makuru afasha ikipe y’abaganga bawe guhindura gahunda y’ubuvuzi uko bikenewe.

Ese wakwitegura ute igihe ugiye kwa muganga?

Kwitunganya igihe ugiye kwa muganga bigufasha kubona byinshi mu ruzinduko rwawe. Kugira amakuru yateguwe neza bituma hakorwa isuzuma n’ubuvuzi byihuse.

Mbere y’uruzinduko rwawe, kora ibi bikurikira:

• Igihe ibimenyetso byatangiye: Igihe ibimenyetso byatangiye n’uko byahindutse
• Amateka y’ubuzima: Ubuvuzi bwakozwe mbere, uburyo wabyaye, n’izindi ndwara
• Imiti ukoresha: Hari imiti yanditswe na muganga, imiti yo mu maduka, n’ibindi
• Amateka y’umuryango: Abagize umuryango wawe barwaye Crohn’s disease cyangwa izindi ndwara
• Ibibazo: Andika ibibazo ushaka kubaza

Ni byiza kuzana inshuti cyangwa umuryango kugira ngo bagufashe. Ntukagire ipfunwe ryo gusaba ibisobanuro niba utasobanukiwe ibyo muganga wawe asobanura. Ni ubuzima bwawe, kandi ukwiye amakuru yumvikana neza.

Ese ni iki gikuru wakura muri rectovaginal fistula?

Rectovaginal fistula ni indwara ikomeye ariko ivurwa isaba ubufasha bw’abaganga. Nubwo ishobora kugira ingaruka ku buzima bwawe bwa buri munsi n’imitekerereze yawe, ubuvuzi burambuye buhari kugira ngo bugufashe gusubiza ubuzima bwawe mu buryo busanzwe.

Ikintu gikomeye cyo kwibuka ni uko utari wenyine muri iki kibazo. Abagore benshi baratsinda iyi ndwara bafashijwe n’ubuvuzi n’ubufasha. Ubuvuzi bwihuse bukunze gutera umusaruro mwiza, nuko ntutinye gushaka ubufasha niba ufite ibimenyetso.

Korana n’abaganga bawe kugira ngo mugire gahunda y’ubuvuzi ikemura ibibazo byawe by’umubiri n’ibyo mu mutwe. Ufite kwihangana n’ubuvuzi bukwiye, abagore benshi barwaye rectovaginal fistulas bashobora gusubira mu buzima bwabo busanzwe.

Ibibazo bikunze kubaho kuri rectovaginal fistula

Ese rectovaginal fistula izakira ukwayo?

Imikaya mito kandi yoroshye rimwe na rimwe ikira idakozweho, cyane cyane iyo imenyekanye hakiri kare kandi ivuwe hakoreshejwe uburyo bworoshye. Ariko, imikaya myinshi ya rectovaginal fistula isaba kubagwa kugira ngo ikire neza. Muganga wawe azamenya uburyo bwiza hashingiwe ku mimerere yawe.

Ese nshobora gutwita niba mfite rectovaginal fistula?

Nubwo gutwita bishoboka ufite rectovaginal fistula, birakunzwe ko iyi myanya y’umubiri ivurwa mbere yo kugerageza gutwita. Gutwita no kubyara bishobora kongera ubukana bw’iyi ndwara cyangwa bigatuma kubaga bigoye. Vugana n’umuganga wawe kugira ngo umenye igihe cyiza cyo kuvura no gutwita.

Ese gukira nyuma yo kubagwa byaramara igihe kingana iki?

Igihe cyo gukira gitandukanye bitewe n’uburyo bwo kubaga n’uburyo bwawe bwite bwo gukira. Abagore benshi bakenera ibyumweru 6-8 kugira ngo bakire, gukira burundu bikamara amezi 3-6. Muganga wawe azakubwira ibyo ugomba gukora n’igihe cyo kuza gusuzuma hashingiwe ku buryo bwo kubaga.

Ese ni ayahe mahirwe yo gukira rectovaginal fistula?

Amahirwe yo gukira atandukanye bitewe n’ibintu nko bunini bw’iyi myanya y’umubiri, aho iherereye, intandaro yayo, n’ubuzima bwawe muri rusange. Imikaya yoroshye ifite amahirwe yo gukira ari 85-95%, mu gihe imikaya igoye ishobora gusaba kubagwa inshuro nyinshi. Umuganga wawe azakubwira ibyo witeze hashingiwe ku mimerere yawe.

Ese rectovaginal fistulas ishobora gusubira nyuma yo kuvurwa?

Gusubira kw’iyi ndwara bishoboka, cyane cyane ku mikaya igoye cyangwa iterwa na Crohn’s disease. Ibyago bigabanuka ku mikaya yoroshye n’igihe ibibazo by’umubiri bigenzurwa neza. Kujya gusuzuma kenshi bifasha kumenya no gukemura ibibazo hakiri kare.