Fistula Recto-Vajinali

Is Fistula y'umuragaro n'igituba ni udukari tugomba kuba tudahari hagati y'igice cyo hasi cy'umwijima munini - umuragaro cyangwa umwanya w'inyuma - n'igituba. Ibintu biri mu mara bishobora gucika muri iyi fistula, bikareka gaze cyangwa umusemburo uca mu gituba.

Is Fistula y'umuragaro n'igituba ishobora guterwa na:

• Imvune mu gihe cyo kubyara.
• Indwara ya Crohn cyangwa izindi ndwara z'umwijima ziterwa n'uburiganya.
• Ubuvuzi bw'amiradiyo cyangwa kanseri mu gice cy'imbere cy'igice cy'ibanga.
• Ingaruka nyuma y'ubuganga mu gice cy'imbere cy'igice cy'ibanga.
• Ingaruka ziterwa na diverticulite, ubwandu bw'udufungu duto, duto duto mu nzira y'igogorwa.

Iyi ndwara ishobora gutuma gaze n'umusemburo ucika mu gituba. Ibi bishobora gutera umubabaro wo mu mutima no mu mubiri, ibyo bishobora kugira ingaruka ku kwihesha agaciro no mu mibanire.

Ganira n'abaganga bawe niba ufite ibimenyetso bya fistula y'umuragaro n'igituba, nubwo byaba bishya. Zimwe muri fistula y'umuragaro n'igituba zishobora kwifunga ubwazo, ariko ubundi zikeneye kubagwa kugira ngo zikemuke.

Ikimenyetso cy'indwara ya rectovaginal fistula gikunze kugaragara ni ukuvamo umwuka cyangwa umusemburo mu gitsina. Bitewe no bunini n'aho iyi fistula iherereye, ushobora kugira ibimenyetso bike. Cyangwa ushobora kugira ibibazo bikomeye byo gutakaza umusemburo n'umwuka no kugumisha ahantu hakeye. Reba umuganga wawe niba ufite ibimenyetso bya rectovaginal fistula.

Gira inama n'abaganga bawe niba ufite ibimenyetso by'igisebe kiri hagati y'umuyoboro w'inyuma n'inda.

Is Fistula ya rectovaginal ishobora guterwa na:

• Imvune mu gihe cyo kubyara. Imvune ziterwa no kubyara niyo mpamvu ikunze gutera fistula ya rectovaginal. Imvune zirimo ibibyimba biri mu gice cyo hagati y'igitsina n'inyuma - uruhu ruri hagati y'igitsina n'umushinya - bikagera mu mara cyangwa ikibazo cy'ubwandu. Fistula iterwa n'imvune mu gihe cyo kubyara ishobora kuba ifitanye isano n'imvune ku mpinduro z'umushinya - imikaya iri ku mpera y'umushinya ifasha mu kubika umwanda.
• Indwara z'umwijima. Impamvu ya kabiri ikunze gutera fistula ya rectovaginal ni indwara ya Crohn, ndetse na ulcerative colitis, nubwo ari nke. Izi ndwara z'umwijima ziterwa no kubyimba no gucika intege kw'imikaya iri mu muhogo w'igogorwa. Abantu benshi barwaye indwara ya Crohn ntibabona fistula ya rectovaginal, ariko kuba ufite indwara ya Crohn byongera ibyago byo kurwara iyi ndwara.
• Cancer cyangwa imiti y'amiradiyo mu gice cy'imbere mu kibuno. Uburibwe bwa kanseri mu mushinya, mu kiziba cy'igitsina, mu gitsina, mu nda cyangwa mu muhogo w'inyuma bishobora gutera fistula ya rectovaginal. Nanone, imiti y'amiradiyo yo kuvura kanseri muri ibi bice ishobora kukushyira mu kaga. Fistula iterwa n'amiradiyo ishobora kubaho igihe icyo aricyo cyose nyuma yo kuvurwa, ariko ikunze kubaho mu myaka ibiri ya mbere.
• Ubuganga bukorerwa mu gitsina, mu gice cyo hagati y'igitsina n'inyuma, mu mushinya cyangwa mu mpinduro. Mu bihe bitoroshye, ubuganga bwakozwe mbere mu gice cyo hasi cy'imbere mu kibuno, nko gukuraho ikibyimba cya Bartholin, bishobora gutera fistula. Ibibyimba bya Bartholin biboneka ku mpande zombi z'igitsina kandi bifasha mu kugumisha igitsina gitose. Fistula ishobora guterwa n'imvune mu gihe cy'ubuganga cyangwa ikibazo cyo gucika cyangwa ubwandu buza nyuma.
• Ingaruka ziterwa na diverticulitis. Ubwandu bw'udufuka duto, duto duto mu muhogo w'igogorwa, bitwa diverticulitis, bishobora gutera umushinya cyangwa umwijima ukomeye gukomera ku gitsina kandi bishobora gutera fistula.
• Izindi mpamvu. Mu bihe bitoroshye, fistula ya rectovaginal ishobora kubaho nyuma y'ubwandu mu ruhu ruri hafi y'umushinya cyangwa igitsina.

Fistule rectovaginale nta bimenyetso by’ubuzima bifatika ifite.

Ingaruka z'igisebe kiri hagati y'umuyoboro w'amabere n'inda zishobora kuba:

• Kutabasha kwifata mu nduru, bikunze kwitwa kudafata mu nduru.
• Kugira ibibazo mu gusukura igice cy'ibitsina.
• Amazi menshi y'indwara z'abagore cyangwa iz'inzira z'umuyoboro w'inkari.
• Kubabara cyangwa kwishima kw'igitsina cy'umugore, igice cy'ibitsina cyangwa uruhu rwo mu kibuno.
• Igisebe gisubira.
• Ibibazo by'ikizere cy'umuntu ubwe n'imibanire.

Mu bantu barwaye indwara ya Crohn bafite igisebe, amahirwe yo kugira ingaruka ni menshi. Ibi bishobora kuba harimo gukira nabi, cyangwa ikindi gisebe kizava nyuma.

Nta ntambwe ugomba gufata kugira ngo wirinda uburwayi bwa fistule rectovaginale.

Kugira ngo umuganga amenye neza niba ufite uburwayi bwa rectovaginal fistula, ashobora kukubaza ibibazo ku birebana n’ibimenyetso ufite, hanyuma akakora isuzuma ng’amaso. Uyu muganga ashobora kugusaba ko wakorerwa ibizamini bimwe na bimwe bitewe n’ibyo ukeneye.

Muganga akora isuzuma ng’amaso kugira ngo ashake aho uburwayi bwa rectovaginal fistula buherereye, kandi arebe niba hari ibindi bibazo nk’igiturika, ubwandu cyangwa igisebe. Isuzuma muri rusange ririmo kureba igitsina cyawe, umwanya w’inyuma, n’agace kari hagati yabyo, kitwa perineum, akoresheje ukuboko kwambaye uturango. Hashobora gukoreshwa igikoresho cyakozwe mu buryo bwihariye kugira ngo cyinjizwe mu mwanya wa fistula kugira ngo kimenye neza aho umwanya wa fistula uherereye.

Uretse niba fistula iri hasi cyane mu gitsina kandi igaragara neza, umuganga ashobora gukoresha igikoresho cyo gufungura ururembo rw’igitsina kugira ngo arebe imbere mu gitsina cyawe. Hari igikoresho gisa n’icyo, kitwa proctoscope, gishobora gukoreshwa ngo kinjizwe mu kibuno no mu mura.

Mu gihe gito cyane, niba umuganga atekereza ko fistula ishobora guterwa na kanseri, ashobora gufata igice gito cy’umubiri kugira ngo akore isuzuma. Ibi bita biopsy. Igice cy’umubiri gifatwa cyoherezwa muri laboratwari kugira ngo barebe uturemangingabo.

Akenshi, uburwayi bwa rectovaginal fistula bugaragara neza mu isuzuma ry’ibice by’imbere by’umubiri. Niba fistula itagaragaye mu isuzuma, ushobora gukenera ibizamini. Ibi bizamini bishobora gufasha itsinda ry’abaganga gushaka no kureba uburwayi bwa rectovaginal fistula, kandi bigafasha gutegura kubagwa, niba bibaye ngombwa.

• CT scan. CT scan y’inda na pelvis itanga amakuru arambuye kurusha X-ray isanzwe. CT scan ishobora gufasha kumenya aho fistula iherereye n’icyo yatewe nacyo.
• MRI. Iki kizami gifata amashusho y’imbere mu mubiri. MRI ishobora kwerekana aho fistula iherereye, niba hari ibindi bice by’imbere by’umubiri birebwa, cyangwa niba ufite igiturika.
• Ibindi bizamini. Niba umuganga atekereza ko ufite indwara y’umwijima, ushobora gukorerwa colonoscopy kugira ngo barebe imbere mu mura. Muri ubu buryo, hashobora gufatwa ibice bito by’umubiri kugira ngo byohererezwe muri laboratwari. Ibyo bice bishobora gufasha kumenya niba ufite indwara ya Crohn cyangwa izindi ndwara z’umwijima.
• Isuzuma rikorerwa uri mu bitaro. Niba ibindi bizamini bitagaragaje fistula, umuganga ashobora gukenera kukusuzuma uri mu cyumba cy’abaganga. Ibi bituma bashobora kureba neza mu kibuno no mu mura, kandi bigafasha kumenya aho fistula iherereye no gutegura kubagwa.