Iyini i-Rectovaginal Fistula? Izimpawu, Izimbangela, & Ukwelashwa

I-rectovaginal fistula iyixhumano elingalungile phakathi kwesisu sakho esikhulu nesikhumba sakho, elivumela ukuba umthondo nomoya udlule ngesikhumba sakho. Lokhu kuvuleka akufanele kube khona, futhi uma kwenzeka, kungazizwa kukhulu futhi kuhlukile. Awuwedwa kulolu daba, futhi kukhona ukwelashwa okuphumelelayo okukhona ukusiza ukubuyisela ikhwalithi yokuphila kwakho.

Iyini i-rectovaginal fistula?

I-rectovaginal fistula yenza indlela efana nethoni phakathi kwesisu sakho esikhulu (ingxenye yokugcina yesisu sakho esikhulu) nesikhumba sakho. Lokhu kuhlangana kuvumela ukuba okuqukethwe kwesisu kugeleze esikhumbeni sakho esikhulu esikhulu kunokuba kuphume ngesikhumba sakho njengoba kwakufanele.

Ubukhulu bale fistulas bungashintsha kakhulu. Ezinye ziyizikhala ezincane, kanti ezinye zingakhulu futhi ziyinkimbinkimbi. Indawo eceleni kodonga lwe-rectovaginal iphinde ishintshe, okuthinta kokubili izimpawu nezindlela zokwelapha.

Lokhu kusimo kuchaphazela impilo yakho yansuku zonke kakhulu, kuchaphazela konke kusukela ekuhlanzeni komuntu siqu kuya ebuhlotsheni obuseduze. Ukuqonda ukuthi kwenzekani emzimbeni wakho yisinyathelo sokuqala sokuthola usizo oludinga.

Ziyini izimpawu ze-rectovaginal fistula?

Isimpawu esibonakalayo kakhulu yilokhu okuqukethwe kwesisu noma umoya odlula esikhumbeni sakho esikhulu esikhulu kunesisu sakho. Lokhu kungenzeka ngokungalindelekile futhi kungazizwa kukhathaza, ikakhulukazi uma uzama ukulawula imisebenzi yakho yansuku zonke.

Nawa izimpawu eziyinhloko ongazihlangabezana nazo:

• Ukugeleza komthondo esikhumbeni sakho esikhulu
• Umoya odlula esikhumbeni sakho esikhulu
• Ukugeleza okunuka kabi esikhumbeni sakho esikhulu
• Ukutheleleka okuphindaphindayo kwesikhumba noma indlela yomchamo
• Ubuhlungu ngesikhathi sokuya esikhumini
• Ukuthukuthela noma ukushisa eduze kwesikhumba sakho esikhulu
• Ubuhlungu ngesikhathi sokuya ocansini
• Ukuqina kwesisu noma ukungakhululeki

Abanye abesifazane baphuthuma ukuthukuthela kwesikhumba eduze kokuvuleka kwesikhumba ngenxa yokuxhumana nomthondo. Umphumela wobuhlungu ungaba nzima njengezimpawu zokwenyama, ngokuvamile uholela ekukhathazeni ngezimo zenhlalo noma ubuseduze.

Ziyini izinhlobo ze-rectovaginal fistula?

Odokotela bahlukanisa i-rectovaginal fistulas ngokusekelwe endaweni yazo nengxube-xube yazo. Ukuqonda uhlobo lwakho oluthile kusiza ekutholeni indlela yokwelapha engcono kakhulu yesimo sakho.

Izinhlobo eziyinhloko zihlanganisa:

• I-rectovaginal fistula ephansi: Itholakala eduze kokuvuleka kwesikhumba, ngokuvamile kulula ukuyilungisa
• I-rectovaginal fistula ephakeme: Itholakala phezulu emgodini wesikhumba, ingadinga ukuhlinzwa okunzima kakhulu
• I-fistula elula: Ukuvulwa okuncane, okulula ngeziqalo ezempilo
• I-fistula eyingxube-xube: Ukuvulwa okukhulu, izindlela eziningi, noma ezizungezwe yizicubu eziqalekisiwe noma eziqalekisiwe

Udokotela wakho uzobona ukuthi yiluphi uhlobo olulokhu unalo ngokuhlolwa nokufunda izithombe. Lokhu kuhlukaniswa kuqondisa kokubili indlela yokwelapha kanye nesikhathi sakho sokuphulukisa okulindelekile.

Yini ebangela i-rectovaginal fistula?

Izimo eziningana ezahlukene zingadala ukuthuthukiswa kwe-rectovaginal fistula. Imbangela evamile kakhulu yizinkinga ngesikhathi sokubeletha, kodwa ezinye izimo zezokwelapha nezinqubo zingadala le mihlangano engalungile.

Izimbangela eziyinhloko zihlanganisa:

• Ukulimala kokubeletha: Ukuklebhuleka okukhulu ngesikhathi sokubeletha kwesikhumba, ikakhulukazi ukuklebhuleka kwezinga lesine okuya esiswini esikhulu
• Isifo sokuvuvukala sesisu: Isifo sikaCrohn singabangela ukuvuvukala okuqeda izicubu phakathi kwezitho
• Izinkinga zokuhlinzwa: Izinkinga ezivela ekulungiseni i-episiotomy, ukuhlinzwa kwe-hemorrhoid, noma ezinye izinqubo ze-pelvic
• Ukwelashwa ngomgogodla: Ukwelashwa komdlavuza endaweni ye-pelvic kungaqeda izicubu ngokuhamba kwesikhathi
• Ukutheleleka: Ama-abscesses amakhulu endaweni phakathi kwesisu esikhulu nesikhumba
• Umdlavuza: Iziphumuzo esiswini esikhulu, esikhumbeni esikhulu, noma e-cervix zingadala ukuvulwa phakathi kwezitho
• Ukulimala kwe-pelvic: Izingozi ezinkulu noma ukulimala endaweni ye-pelvic

Kwezinye izimo ezingavamile, abanye abesifazane bazalwa ne-rectovaginal fistulas ngenxa yezinkinga zokuthuthukiswa ngesikhathi sokukhulelwa. Ngezinye izikhathi imbangela eqondile ayicaci, okutholakala kukhathaza kodwa akukuthinti ukwelashwa kwakho.

Kufanele ubona nini udokotela nge-rectovaginal fistula?

Kufanele uxhumane nodokotela wakho ngokushesha uma uqaphela ukugeleza komthondo noma umoya ovela esikhumbeni sakho esikhulu. Lesi simpawu sihlale sidinga ukuhlolwa kwezokwelapha, njengoba akuyona into ezophulukisa ngokwayo.

Funani ukunakekelwa kwezokwelapha uma uhlangabezana nanoma yiziphi izimpawu:

• Nanoma iyiphi inani lomthondo odlula esikhumbeni sakho esikhulu
• Ukugeleza okunuka kabi kwesikhumba esikhulu
• Ukutheleleka okuphindaphindayo kwesikhumba noma indlela yomchamo
• Ubuhlungu obukhulu ngesikhathi sokuya esikhumini noma ekuhlanganyeleni kocansi
• Izimpawu zokutheleleka njengoba ubushushu bomzimba, ukubanda, noma ubuhlungu be-pelvic obukhulu

Ukwelashwa kwasekuqaleni kuvame ukuletha imiphumela emihle futhi kungavimbela izinkinga. Ungazizwa uhluphekile ngokuxoxa ngalezi zimpawu nodokotela wakho - bayeqeqeshwe ukusingatha lezi zimo ngokuziphatha okuzwelayo nobuchwepheshe.

Ziyini izici ezingaholela ekuthuthukiseni i-rectovaginal fistula?

Izici ezithile zingandisa amathuba akho okuthuthukisa i-rectovaginal fistula. Ukuqonda lezi zici ezingaholela ekuthuthukiseni i-rectovaginal fistula kusiza wena neqembu lakho lokunakekelwa kwezokwelapha ukwenza izinqumo ezilwemi ngokuvikela nokwelapha.

Izici eziyinhloko ezingaholela ekuthuthukiseni i-rectovaginal fistula zihlanganisa:

• Ukubeletha okunzima: Ukubeletha okude, ukusetshenziswa kwe-forceps noma i-vacuum, noma ingane enkulu
• Ukuhlinzwa kwangaphambili kwe-pelvic: Umlando wezinqubo endaweni yesikhumba noma esikhumbeni esikhulu
• Isifo sokuvuvukala sesisu: Ikakhulukazi isifo sikaCrohn esichaphazela isisu esikhulu
• Ukwelashwa ngomgogodla kwangaphambili: Ukwelashwa komdlavuza okuqondiswe endaweni ye-pelvic
• Ubudala obukhulu ngesikhathi sokubeletha: Ukuba ngaphezu kweminyaka engama-35 ngesikhathi sokubeletha
• Ukuvimbela umchamo okuqhubekayo: Ukuzindla isikhathi eside ngesikhathi sokuya esikhumini
• Ukondleka okubi: Izimo eziqeda ukuphulukisa izicubu
• Ukubhema: Kuqeda ukugeleza kwegazi nokuphulukisa izicubu

Ukuba nezici ezingaholela ekuthuthukiseni i-rectovaginal fistula akusho ukuthi uzokuthuthukisa ngokuqinisekile i-fistula. Abesifazane abaningi abanezi zici ezingaholela ekuthuthukiseni i-rectovaginal fistula abazange bahlangabezane nale simo, kanti abanye abangenazo izici ezingaholela ekuthuthukiseni i-rectovaginal fistula ebonakalayo bayithuthukisa i-fistulas.

Ziyini izinkinga ezingase zenzeke ngenxa ye-rectovaginal fistula?

Uma kushiywa ingalashwa, i-rectovaginal fistulas ingadala izinkinga eziningana ezichaphazela impilo yakho yomzimba nekhwalithi yokuphila. Ukuqonda lezi zinkinga ezingase zenzeke kugcizelela ukuthi kungani ukufuna ukwelashwa kubalulekile kangaka.

Izinkinga ezingase zenzeke zihlanganisa:

• Ukutheleleka okuphindaphindayo: Ukutheleleka okuvamile kwesikhumba, indlela yomchamo, noma i-pelvic
• Ukuqhekeka kwesikhumba: Ukuthukuthela namabala eduze kwesikhumba esikhulu nesikhumba
• Ukuhlukaniswa komphakathi: Ubunzima bokuqhubeka nemisebenzi evamile ngenxa yokuphunga nokugeleza
• Ukungasebenzi kahle kocansi: Ubuhlungu ngesikhathi sokuya ocansini nokucindezeleka kobuhlobo
• Usizi lwengqondo: Ukudideka, ukukhathazeka, nokulahlekelwa ukuzethemba
• Ukungahlangani kahle kwama-electrolyte: Kwezinye izimo ezingavamile nge-fistulas enkulu ebangela ukulahleka okukhulu koketshezi

Izindaba ezinhle ukuthi ngokwelashwa okufanele, izinkinga eziningi zivimbeka noma zibuyiswe. Iqembu lakho lokunakekelwa kwezokwelapha lizokusebenza nawe ukusingatha kokubili izici zokwenyama nezingqondo zalesi simo.

I-rectovaginal fistula ihlonishwa kanjani?

Udokotela wakho uzoqala ngengxoxo eningiliziwe ngezimpawu zakho nomlando wakho wezokwelapha. Bazokuqondisa ngamava okubeletha, ukuhlinzwa kwangaphambili, nanoma yiziphi izimo zokuvuvukala sesisu ukuqonda izimbangela ezingase zenzeke.

Inqubo yokuhlola ngokuvamile ihlanganisa ukuhlolwa komzimba lapho udokotela wakho ehlola ngobumnene izindawo zakho zesikhumba nesikhumba. Lokhu kuhlolwa kungazizwa kungakhululeki, kodwa kuyadingeka ukuthola i-fistula nokulinganisa ubukhulu bayo nengxube-xube yayo.

Izivivinyo ezengeziwe zingase zihlanganise:

• I-Fistulogram: I-X-ray ene-contrast dye ukuze ibonise indlela ye-fistula
• I-CT scan noma i-MRI: Izithombe ezinemininingwane ukuze ubone izicubu ezizungezile futhi ukhanyise ezinye izimo
• I-Colonoscopy: Ukuhlolwa kwekhamera kwesisu sakho ukuze uhlole isifo sokuvuvukala sesisu
• I-Anorectal manometry: Izivivinyo zokulinganisa umsebenzi we-sphincter anal
• I-Endorectal ultrasound: Izithombe ze-sound wave ukuze uhlulele imisipha ye-anal sphincter

Udokotela wakho angase futhi enze i-methylene blue test, lapho i-dye blue ibekwa esiswini sakho esikhulu ukuze ubone ukuthi ivela yini esikhumbeni sakho esikhulu. Lezi zivivinyo zisiza ekwenzeni isithombe esiphelele sesimo sakho nokukhomba ukuhlelwa kokwelapha.

Yini ukwelashwa kwe-rectovaginal fistula?

Ukwelashwa kuncike ezintweni eziningana ezihlanganisa ubukhulu nendawo ye-fistula yakho, imbangela yayo, nempilo yakho jikelele. Udokotela wakho uzothuthukisa uhlelo lokwelapha oluqondene nawe olukuhlinzeka ngamathuba amahle okuphulukisa okuphumelelayo.

I-fistulas encane, elula ngezinye izikhathi iphulukisa ngokwayo ngokuphathwa okuqondene. Le ndlela ingase ihlanganise ukushintsha kokudla, imithi yokunciphisa ukuya esikhumini, kanye nezindlela zokuhlanza ngokucophelela. Udokotela wakho uzolandelela intuthuko yakho eduze ngalesi sikhathi.

Ukulungiswa okuhlinzwa ngokuvamile kudingeka nge-fistulas enkulu noma eyingxube-xube. Izindlela eziyinhloko zokuhlinzwa zihlanganisa:

• I-Fistulotomy: Ukuvula nokuhlanza indlela ye-fistula
• Ukulungiswa kwe-flap ekuthuthukisweni: Ukusebenzisa izicubu ezempilo ukuvala ukuvulwa
• Ukuhlanganiswa kwemisipha: Ukubekwa kwesicubu semisipha phakathi kwesisu esikhulu nesikhumba
• I-colostomy yesikhashana: Ukuqondisa umthondo kude nendawo ukuze kuvumele ukuphulukisa

Nge-fistulas ebangelwa isifo sikaCrohn, udokotela wakho angase anikeze imithi yokunciphisa ukuvuvukala ngaphambi kokuzama ukulungiswa okuhlinzwa. Le ndlela ehlangene ngokuvamile iphumelela kakhulu.

Ungazilawula kanjani izimpawu ekhaya?

Ngesikhathi ulinde ukwelashwa noma ngesikhathi sokuphulukisa, amasu amaningi okunakekelwa ekhaya angakusiza ukuba ulawule izimpawu futhi ugcine ukududuzeka kwakho. Lezi zindlela zisebenza kanye nokwelashwa kwezokwelapha, hhayi njengokushintshwa kokunakekelwa kobuchwepheshe.

Amathuluzi okulawula ekhaya awusizo ahlanganisa:

• Ukuhlanza okuthambile: Hlanza indawo ngamanzi afudumele ngemuva kokuthi uhambe esikhumini
• Ama-barrier creams: Faka i-zinc oxide noma i-petroleum jelly ukuvikela isikhumba ekuthukutheleni
• Ukushintsha kokudla: Dlala ukudla okune-residue encane ukunciphisa ubuningi bomthondo nokuvamile
• Uketshezi olufanele: Phuza amanzi amaningi ukuze ugcine umthondo omuhle
• Izingubo ezanelisayo: Gqoka izinto eziqina, eziphefumula futhi ushintshe izingubo zangaphansi njalo
• Ama-Sitz baths: Ngena emanzini afudumele imizuzu engama-10-15 ukuze ududuze izicubu ezithukuthele

Cabanga ukuqapha idayari yesimpawu ukuze uqaphele izibonelo nezici. Lolu lwazi lusiza iqembu lakho lokunakekelwa kwezokwelapha ukulungisa uhlelo lwakho lokwelapha njengoba kudingeka.

Kufanele uzilungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela i-aphoyintimenti yakho kusiza ukuqinisekisa ukuthi uthola okuningi kakhulu ekuhambeleni kwakho nodokotela wakho. Ukuba nolwazi oluhleliwe okulungile kuvumela ukuhlolwa nokuhlelwa kokwelapha okuphumelelayo.

Ngaphambi kwe-aphoyintimenti yakho, buthana lolu lwazi:

• Isikhathi sesimpawu: Lapho izimpawu zaqala nokuthi zishintshile kanjani
• Umlando wezokwelapha: Ukuhlinzwa kwangaphambili, amava okubeletha, nezimo eziqhubekayo
• Imithi yamanje: Hlanganisa imithi yokwelapha, imithi yokuthengwa ngaphandle komthetho, kanye nezithasiselo
• Umlando womndeni: Noma yimiphi izihlobo ezine-inflammatory bowel disease noma izimo ezifanayo
• Uhlu lwemibuzo: Bhala phansi ukukhathazeka ofuna ukulixoxa

Kusiza ukuletha umngani othembekile noma ilungu lomndeni lokuthola ukwesekwa ngokomzwelo. Unganqikazi ukucela incazelo uma ungaqondi lutho udokotela wakho akuchaza. Lokhu yimpilo yakho, futhi ufanele ulwazi olucacile, oluphelele.

Yini okufanele uyikhumbule nge-rectovaginal fistula?

I-rectovaginal fistula yisimo esinzima kodwa esingaphatheka esidinga ukunakekelwa kwezokwelapha. Ngenkathi ingachaphazela impilo yakho yansuku zonke nokunethezeka kwakho ngokomzwelo, ukwelashwa okuphumelelayo kukhona ukusiza ukubuyisela impilo yakho nekhwalithi yokuphila.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi awuwedwa kulolu daba. Abesifazane abaningi baye baqeda ngempumelelo lesi simo ngokunakekelwa kwezokwelapha nokusekelwa okuhle. Ukwelashwa kwasekuqaleni ngokuvamile kuholela emiphumeleni emihle, ngakho ungalibeki ukufuna usizo uma uhlangabezana nezimpawu.

Sebenzani eduze neqembu lakho lokunakekelwa kwezokwelapha ukuthuthukisa uhlelo lokwelapha oluqondene nezidingo zakho zokwenyama nezingqondo. Ngokubekezela nokunakekelwa okufanele, abesifazane abaningi abane-rectovaginal fistulas bangabuyela emisebenzini yabo evamile nobuhlobo.

Imibuzo evamile ebuzwa nge-rectovaginal fistula

Ingabe i-rectovaginal fistula izophulukisa ngokwayo?

I-fistulas encane, elula ngezinye izikhathi iphulukisa ngaphandle kokuhlinzwa, ikakhulukazi uma itholwe ngokushesha futhi ilawulwe ngokwelashwa okuqondene. Noma kunjalo, i-rectovaginal fistulas eningi idinga ukulungiswa okuhlinzwa ukuze iphulukise ngokuphelele. Udokotela wakho uzobona indlela engcono kakhulu ngokusekelwe esimweni sakho esithile.

Ngingakhulelwa yini uma ngine-rectovaginal fistula?

Ngenkathi ukukhulelwa kunokwenzeka nge-rectovaginal fistula, ngokuvamile kunconywa ukulungisa i-fistula ngaphambi kokuzimisela ukukhulelwa. Ukukhulelwa nokubeletha kungenza lesi simo sibe sibi noma kwenze ukulungiswa okuhlinzwa kube nzima kakhulu. Xoxani ngokuceba komndeni nodokotela wakho ukuze unqume isikhathi esifanele sokwelashwa nokukhulelwa.

Kuthatha isikhathi esingakanani ukuphulukisa ngemuva kokuhlinzwa kokulungisa i-fistula?

Isikhathi sokuphulukisa sihluka kuye ngohlobo lokuhlinzwa nenqubo yakho yokuphulukisa yomuntu siqu. Abesifazane abaningi badinga amasonto angu-6-8 okuphulukisa okuqalayo, ngokuphulukisa okuphelele okuthetha izinyanga ezingu-3-6. Udokotela wakho uzonikeza imikhawulo yemisebenzi ethile nezinhlelo zokulandelela ngokusekelwe enkambweni yakho yokwelapha.

Iyini izinga lokuphelela lokulungiswa kwe-rectovaginal fistula?

Izinga lokuphelela lihluka kuye ngezinto ezifana nobukhulu be-fistula, indawo, imbangela, nempilo yakho jikelele. I-fistulas elula inezilinganiso zokuphelela ezingama-85-95%, kanti i-fistulas eyingxube-xube ingadinga izinqubo eziningi. Udokotela wakho uzoxoxa ngokulindelekile okuqondile ngokusekelwe esimweni sakho esithile.

Ingabe i-rectovaginal fistulas ingabuya ngemuva kokwelashwa?

Ukuphindaphinda kunokwenzeka, ikakhulukazi nge-fistulas eyingxube-xube noma lezo ebangelwa isifo sokuvuvukala sesisu. Ingozi incintisana ne-fistulas elula futhi lapho izimo eziyinhloko zilawulwa kahle. I-aphoyintimenti yokulandelela njalo iyasiza ekutholeni nasekulungiseni noma yiziphi izinkinga ngokushesha uma zenzeka.