Ukuthini i-Vaginal Fistula? Izimpawu, Izimbangela, & Ukwelashwa

I-vaginal fistula iyindawo evulekile noma ukuxhumana okungafanele phakathi kwesikhumba sakho se-vagina nezinye izitho, njengesibeletho sakho, i-rectum, noma amabele. Cabanga ngakho njengendlela engathandeki ekuvumela ukuba amanzi noma ukhondo kudlule endaweni kwenye lapho kungafanele khona.

Lesi simo singazizwa sinzima uma uqala ukusifunda, kodwa awuwedwa. I-Vaginal fistulas ithonya izinkulungwane zabesifazane emhlabeni jikelele, futhi kukhona ukwelashwa okuphumelelayo okutholakala ukusiza ukubuyisela ukuthula kwakho nokuphumelela kokuphila.

Zithini izimpawu ze-vaginal fistula?

Izimpawu ozibonayo ziyahluka kuye ngokuthi yiziphi izitho ezixhunyiwe yi-fistula. Abesifazane abaningi baphawula ukukhishwa okungavamile noma ukucela okungafani nezindlela zabo ezivamile.

Nazi izimpawu ezivame kakhulu okumele uzibheke:

• Ukucela okuqhubekayo kokushisa kwe-vagina (ngezifo ze-bladder)
• Ukudlula komoya noma ukhondo nge-vagina (ngezifo ze-bowel)
• Ukukhishwa okungavamile kwe-vagina okunuka okunamandla noma okubi
• Ukutheleleka okuvamile kwe-urinary tract
• Ubuhlungu noma ukungakhululeki ngesikhathi sokuya ocansini
• Ukucaphuna noma ukushisa eduze kwendawo yakho ye-vagina
• Ukukhuluphala kokulawula ukushisa noma ukunyakaza kwamabele

Lezi zimpawu zingathinta kakhulu impilo yakho yansuku zonke nokuthula kwakho kwengqondo. Uma uhlangabezana nanoma yiziphi zalezi zimpawu, ukufinyelela kumhlinzeki wakho wezempilo kuyisinyathelo esibalulekile sokuthola ukunakekelwa okudingayo.

Ziyini izinhlobo ze-vaginal fistula?

I-Vaginal fistulas ihlukaniswe ngokusekelwe ezinye izitho ezixhuma. Uhlobo ngalunye lubangela izimpawu ezahlukene futhi ludinga izindlela zokwelapha ezithile.

Izinhlobo eziyinhloko zihlanganisa:

• I-Vesicovaginal fistula: Ixhuma isibeletho sakho kwi-vagina yakho, ibangele ukucela kokushisa okuqhubekayo
• I-Rectovaginal fistula: Ixhuma i-rectum yakho kwi-vagina yakho, ivumela umoya nokukhonza ukudlula nge-vagina yakho
• I-Enterovaginal fistula: Ixhuma isisu sakho esincane kwi-vagina yakho
• I-Colovaginal fistula: Ixhuma isisu sakho esikhulu (i-colon) kwi-vagina yakho
• I-Urethrovaginal fistula: Ixhuma i-urethra yakho kwi-vagina yakho

I-Vesicovaginal ne-rectovaginal fistulas yizinhlobo ezivame kakhulu. Udokotela wakho uzobona ukuthi yiluphi uhlobo olukhona ngokuhlola ngokucophelela nokulinga, okusiza ukuqondisa uhlelo lokwelapha oluphumelelayo.

Yini ebangela i-vaginal fistula?

I-Vaginal fistulas ngokuvamile ithuthukiswa lapho izicubu phakathi kwezitho zilimale noma zibuthakathaka. Lolu limale lungenzeka kancane kancane ngokuhamba kwesikhathi noma ngokuzumayo ngenxa yokulimala noma izinqubo zezokwelapha.

Ukuqonda izimbangela ezahlukene kungakusiza wena nodokotela wakho ukubona ukuthi yini engase ibe yimbangela yesimo sakho:

• Izinkinga zokubeletha: Ukusebenza okuphakathi nxesha elide, ukulethwa okunzima, noma izinyembezi ngesikhathi sokubeletha
• Izinkinga zokuthuthukiswa: Ngokungavamile, ukuhlinzwa kwe-gynecological njenge-hysterectomy noma i-cesarean section
• I-Inflammatory bowel disease: Izimo ezinjenge-Crohn's disease noma i-ulcerative colitis
• Ukwelashwa nge-radiation: Ukwelashwa kwezinhlungu ze-pelvic kungabuthakathaka izicubu ngokuhamba kwesikhathi
• Ukutheleleka: Ukutheleleka okukhulu kwe-pelvic noma ama-abscesses
• Umshayeli: Izicubu endaweni ye-pelvic zingadala ukuxhumana okungafanele
• Ukuhlinzwa kwangaphambili kwe-pelvic: Nanoma yikuphi ukuhlinzwa endaweni ye-pelvic kuhlanganisa ingozi encane

Ezinye izimbangela ezingavamile zihlanganisa ukuxhaphaza okukhulu okubangela ukulimala kwezicubu, ezinye izifo ezithathelwanayo ngocansi, noma izimo ezingokwemvelo ezikhona kusukela ekuzalweni. Udokotela wakho uzosebenza nawe ukuze ubone imbangela evamile kakhulu esimweni sakho esithile.

Nini okumele ubheke udokotela nge-vaginal fistula?

Kufanele uxhumane nomhlinzeki wakho wezempilo ngokushesha uma uqaphela ukucela okungavamile kusuka kwi-vagina yakho noma ukuguqulwa kwemisebenzi yakho yomzimba evamile. Ukulingwa kwasekuqaleni kungavimbela izinkinga futhi kuthuthukise imiphumela yokwelapha.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nalokhu:

• Ukucela okuqhubekayo kokushisa kwe-vagina
• Umoya noma ukhondo oluhamba nge-vagina yakho
• Ukukhishwa okuqhubekayo, okunuka okubi kwe-vagina
• Ukutheleleka okuphindaphindayo kwe-urinary tract
• Ubuhlungu obukhulu endaweni yakho ye-pelvic
• Izimpawu zokutheleleka njengobushushu noma ukuthandaza

Ungalindi noma uzizwe uhluphekile ngokuxoxa ngalezi zimpawu. Umhlinzeki wakho wezempilo unekhono kulezi zimo futhi ufuna ukukusiza uzizwe kangcono. Ngokushesha nje lapho ufuna ukunakekelwa, izindlela zokwelapha eziningi zingatholakala kuwe.

Ziyini izici ezingozi ze-vaginal fistula?

Izici ezithile zingandisa amathuba akho okukhula kwe-vaginal fistula. Ukuba nomqondo walezi zici ezingozi kusiza iqembu lakho lezempilo ukunikeza ukunakekelwa okuvimbelayo kangcono nokubheka.

Izici ezingozi ezibaluleke kakhulu zihlanganisa:

• Umlando wokubeletha okunzima: Ukusebenza okuphakathi nxesha elide, ukulethwa kwe-forceps, noma ukubeletha okuningi
• Ukuhlinzwa kwangaphambili kwe-pelvic: Nanoma yikuphi ukuhlinzwa endaweni ye-pelvic, ikakhulu izinqubo eziningi
• I-Inflammatory bowel disease: I-Crohn's disease ikakhulukazi yandisa ingozi
• Ukwelashwa nge-pelvic radiation: Ukwelashwa kwezinhlungu ze-cervical, uterine, noma i-rectal
• Iminyaka ephakeme: Izicubu ziyaba buthakathaka ngokuhamba kwesikhathi
• Izimo zempilo ezingapheli: I-Diabetes noma izimo ezihlasela ukululama
• Ukubhema: Kuncipha ukugeleza kwegazi futhi kunciphise ukululama kwezicubu

Izici ezingavamile ezingozi zihlanganisa izimo ezithile ze-autoimmune, ukusetshenziswa kwesikhathi eside se-steroid, noma umlando wokutheleleka kwe-pelvic. Ukuba nezici ezingozi akusho ukuthi uzokhula ngokuqinisekile i-fistula, kodwa udokotela wakho angakuncoma ukubheka eduze uma izici eziningi zikusebenza kuwe.

Ziyini izinkinga ezingase zenzeke nge-vaginal fistula?

Ngaphandle kokwelashwa, i-vaginal fistulas ingabangela izinkinga eziningi ezithinta impilo yakho yomzimba nokuphumelela kokuphila. Izindaba ezinhle ukuthi izinkinga eziningi zingavikeleka noma ziphathwe ngokunakekelwa kwezokwelapha okufanele.

Izinkinga zomzimba zingafaka:

• Ukutheleleka okuphindaphindayo: Ukutheleleka kwe-urinary tract noma ukutheleleka kwe-vagina
• Ukucaphuna kwesikhumba: Ukufuma okuqhubekayo kungabangela ama-rashes noma ama-sores
• Ukusebenza okungalungile kocansi: Ubuhlungu noma ukungakhululeki ngesikhathi sokuya ocansini
• Ukungahlangani kahle kwe-electrolyte: Ukwehluleka kwaminerali abalulekile ngokucela okuqhubekayo
• Izinkinga zezinkalakatha: Ezimweni ezinkulu ngezifo ze-bladder

Umphumela wengqondo ungaba nzima ngokulinganayo, kuhlanganise nokuzithoba komphakathi, ukucindezeleka, noma ukukhathazeka ngenhlamba nokucela. Abesifazane abaningi nabo bahlangabezana nokuhlupheka kobuhlobo noma ukwehla kokuzethemba.

Khumbula ukuthi lezi zinkinga zingavikeleka ngokwelashwa okufanele. Iqembu lakho lezempilo liyaqonda lezi zinselele futhi linganikeza kokubili ukwelashwa kwezokwelapha nokusekela ngokomzwelo kulo lonke uhambo lwakho lokuphulukisa.

Ingavikeleka kanjani i-vaginal fistula?

Nakuba akuyona yonke i-vaginal fistulas engavikeleka, izinyathelo ezithile zinganciphisa ingozi yakho kakhulu. Ukuvimbela kugxile ekugcineni impilo enhle ye-pelvic nokuphatha izimo ezingapheli ngokuphumelelayo.

Amasu okuvimbela ayinhloko ahlanganisa:

• Ukukhathalela okufanele kwangaphambi kokubeletha: Ukuhlola okuvamile ngesikhathi sokukhulelwa nokuba khona kokubeletha okufundisiwe
• Ukuphatha izimo ezingapheli: Gcina i-inflammatory bowel disease noma i-diabetes ilawulwe kahle
• Ukugwema ukubhema: Ukusetshenziswa kwe-tobacco kuncipha ukululama futhi kukhulise izinkinga zokuthuthukiswa
• Ukulandela imiyalo yangemva kokuhlinzwa: Vumela isikhathi esifanele sokululama ngemva kwanoma yikuphi ukuhlinzwa kwe-pelvic
• Ukwelapha ukutheleleka ngokushesha: Qaphela ukutheleleka kwe-pelvic ngokushesha nangokuphelele
• Ukugcina ukuhlanzeka okuhle: Gcina indawo ye-genital ihlanzekile futhi yomile

Uma ungozini enkulu ngenxa yezimo zezokwelapha noma ukuhlinzwa kwangaphambili, xoxa ngamasu okuvimbela nodokotela wakho. Bangakuncoma ukubheka okuthile noma izinyathelo zokuqapha ezilungiselelwe isimo sakho.

I-vaginal fistula ihlonishwa kanjani?

Ukuhlonishwa kwe-vaginal fistula kuhlanganisa ukuhlanganiswa kokuhlola komzimba nokulinga okukhethekile. Udokotela wakho uzosebenza ngendlela ehlelekile ukuqinisekisa ukuba khona kwe-fistula futhi aqonde indawo yayo nekhulu.

Inqubo yokuhlola ngokuvamile ihlanganisa:

• Ukubuyekezwa komlando wezokwelapha: Ingxoxo yezimpawu zakho, ukuhlinzwa, nezici ezingozi
• Ukuhlola komzimba: Ukubuka ngokucophelela indawo yakho ye-vagina ne-pelvic
• Ukuhlola kwe-speculum: Ukubuka ngqo izindonga ze-vagina
• Izivivinyo ze-dye: I-dye ekhethekile ikusiza ukulandelela ukuxhumana okungafanele
• Izifundo ze-imaging: I-CT scans, i-MRI, noma i-ultrasound ukubona izakhiwo zangaphakathi
• I-Cystoscopy: Ukubuka ngekhamera isibeletho sakho uma kudingeka
• I-Colonoscopy: Ukubuka i-colon yakho ngezifo ze-bowel

Lezi zilingo zingase zizwe zinzima, kodwa ngokuvamile ziyamukeleka futhi zinikeza ulwazi olubalulekile lokucwangcisa ukwelashwa kwakho. Iqembu lakho lezempilo lizochaza ngalinye ilungo futhi likusize uzizwe ukhululekile kulo lonke inqubo.

Yini ukwelashwa kwe-vaginal fistula?

Ukwelashwa kwe-vaginal fistula kuncike ekukhulu, indawo, nombangela wesimo sakho esithile. I-fistulas eminingi ingalungiswa ngempumelelo, ikuvumela ukuba ubuyele emsebenzini ovamile nokuthula.

Izindlela zakho zokwelapha zingafaka:

• Ukuphathwa okuqondile: I-fistulas encane ngezinye izikhathi iyalulama yodwa ngokunakekelwa okufanele
• Ukulungiswa kokuthuthukiswa: Ukwelashwa okuvamile nokuphumelelayo lwe-fistulas enkulu
• Izinqubo ezincane zokuthuthukiswa: I-Laparoscopic noma i-robotic surgery lapho kufaneleka khona
• Izicubu ze-grafts: Ukusebenzisa izicubu zakho ukuqinisa ukulungiswa
• Ukulungiswa okuhlanganisiwe: Ukuhlinzwa okuncane okuningi kwezimo eziyinkimbinkimbi
• Ukuphathwa kwezokwelapha: Ukwelapha izimo ezingapheli njenge-inflammatory bowel disease

Udokotela wakho uzokhetha indlela engcono kakhulu ngokusekelwe esimweni sakho somuntu siqu. Amanani okuphumelela kokulungiswa kwe-fistula ngokuvamile aphezulu, ikakhulukazi uma enziwa ochwepheshe abanolwazi. Isikhathi sokululama siyahluka, kodwa abesifazane abaningi babona ukuthuthuka okukhulu phakathi nezinyanga ezimbalwa.

Indlela yokuphatha izimpawu ekhaya ngesikhathi sokwelashwa?

Ngesikhathi ulinde ukwelashwa noma ngesikhathi sokululama, amasu athile okunakekelwa ekhaya angakusiza ukuphatha izimpawu nokugcina ukuthula kwakho. Lezi zindlela zisebenza kanye nokwelashwa kwezokwelapha, hhayi njengokushintsha ukunakekelwa kochwepheshe.

Amasu okuphatha asebenzayo ahlanganisa:

• Sebenzisa imikhiqizo ebonakalayo: Ama-pads aphezulu noma ama-diapers abantu abadala ukuvikela ukucela
• Yenza ukuhlanzeka okuthambile: Hlanza indawo njalo ngesepu elithambile, elingenasono
• Faka ama-barrier creams: Vikela isikhumba sakho ekucasukeni okubangelwa ukufuma okuqhubekayo
• Hlala uthambile: Phuza amanzi amaningi naphezu kokukhathazeka ngokucela
• Gqoka izingubo eziqondile: Vumela ukugeleza komoya ukuvimbela izinkinga zesikhumba
• Thatha izimbobo ezishisayo: Faka emanzini ashisayo ukuthula isikhumba esicasukile
• Gwema imikhiqizo eqinile: Gwema ama-douches, imikhiqizo enenhlamba, noma izinto zokugeza ezinamandla

Cabanga ukugcina idayari yezimpawu ukuze ulandelele izinguquko futhi ubone izindlela. Lolu lwazi lungaba lubalulekile kumhlinzeki wakho wezempilo lapho ucwangcisa ukulungiswa kokwelapha.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela ngokuphelele i-aphoyintimenti yakho kusiza ukuqinisekisa ukuthi uthola ulwazi oluwusizo kakhulu nokunakekelwa. Udokotela wakho udinga imininingwane ethile mayelana nezimpawu zakho nomlando wezokwelapha ukuze anikeze izincomo zokwelapha ezinhle kakhulu.

Ngaphambi kwendlu yakho, buza le mininingwane elandelayo:

• Isikhathi sesimpawu: Izimpawu zaqala nini futhi ziguquke kanjani?
• Amarekhodi wezokwelapha: Letha imibiko evela ekuhlinzweni kwangaphambili noma izinqubo ezifanele
• Imithi yamanje: Faka imithi ye-prescription, izithasiselo, nemikhiqizo ye-over-the-counter
• Umlando womndeni: Noma yimiphi izihlobo ezinezimo ezifanayo noma i-inflammatory bowel disease
• Izici zokuphila: Ulwazi mayelana nokubhema, ukudla, noma ezinye izindlela zempilo

Bhala imibuzo yakho ngaphambi kwesikhathi ukuze ungakhohlwa ukubuza izinto ezibalulekile ngesikhathi se-aphoyintimenti. Cabanga ukuletha umngani othembekile noma ilungu lomndeni ukuze uthole ukusekela, ikakhulukazi uma uzizwa ukhathazekile ngendlu.

Yini ukubamba okubalulekile mayelana ne-vaginal fistula?

I-Vaginal fistulas yizimo ezinzima, kodwa ingalashwa ngokunakekelwa kwezokwelapha okufanele nokusekela. Into ebaluleke kakhulu okumele uyikhumbule ukuthi awudingi ukuhlupheka ngokuthula noma uzizwe uhluphekile ngokufuna usizo.

Ukuhlonishwa kwasekuqaleni nokwelashwa ngokuvamile kuholela emiphumeleni emihle nezinkinga ezincane. Amathuluzi okuhlinzwa anamazinga aphezulu okuphumelela, futhi abesifazane abaningi babuyela emsebenzini ovamile ngemva kokwelashwa. Iqembu lakho lezempilo linekhono kulezi zimo futhi lifuna ukukusiza uzizwe ukhululekile futhi uqiniseke futhi.

Nakuba uhambo lokuphulukisa lungathatha isikhathi, khumbula ukuthi ukwelashwa okuphumelelayo kutholakala. Gxila ekufuneni abahlinzeki bezempilo abanolwazi, ukulandela izincomo zokwelapha, nokuba nesineke nenqubo yokululama. Ngokunakekelwa okufanele, ungalindela ukuthuthuka okukhulu ezimpawu zakho nokuphumelela kokuphila.

Imibuzo evamile ebuzwayo mayelana ne-vaginal fistula

Q1: Ingalulama yodwa i-vaginal fistulas ngaphandle kokuhlinzwa?

I-fistulas encane, elula ngezinye izikhathi iyalulama ngokwemvelo, ikakhulukazi uma ithuthukiswe muva nje ngemva kokuhlinzwa noma ukubeletha. Noma kunjalo, i-fistulas eminingi idinga ukulungiswa kokuthuthukiswa ukuze iphulukiswe ngokuphelele. Udokotela wakho uzobheka i-fistulas encane eduze ukuze abone ukuthi iyalulama ngokwelashwa okuqondile ngaphambi kokuncoma ukuhlinzwa.

Q2: Isikhathi sokululama singakanani ngemva kokuhlinzwa kokulungisa i-fistula?

Isikhathi sokululama siyahluka kuye ngohlobo nobunzima bokuhlinzwa kwakho. Abesifazane abaningi badinga amasonto angu-6-12 ukuze balulame ekuqaleni, lapho uzodinga khona ukugwema ukuphakamisa okunzima nokuya ocansini. Ukululama okuphelele nokubuyela kuyo yonke imisebenzi evamile ngokuvamile kuthatha izinyanga ezingu-3-6. Udokotela wakho uzonikeza imiyalo ethile ngokusekelwe enkambweni yakho.

Q3: Ngizokwazi yini ukuba nobuhlobo obuvamile bocansi ngemva kokwelashwa?

Yebo, abesifazane abaningi babuyela emsebenzini ovamile wocansi ngemva kokulungiswa okuphumelelayo kwe-fistula. Udokotela wakho uzokuncoma lapho kuphephile khona ukubuyela emsebenzini wocansi, ngokuvamile ngemva kokululama okuphelele. Abesifazane abanye bangadinga ukwelashwa okwengeziwe njenge-pelvic floor therapy ukubhekana nanoma yikuphi ukukhathazeka okusele mayelana nokuthula noma ukuzethemba.

Q4: Ingabe kunoma yikuphi ukuguqulwa kokudla okumele ngikwenze nge-vaginal fistula?

Nge-fistulas ehlobene namabele, udokotela wakho angakuncoma ukuguqulwa kokudla okwesikhashana ukuze unciphise ukunyakaza kwamabele ngesikhathi sokululama. Lokhu kungafaka ukudla okune-fiber encane noma ukugwema ukudla okuthile okubangela igesi noma ama-stools aluhlaza. Nge-fistulas ze-bladder, ukugcina uthambile kubalulekile naphezu kokukhathazeka ngokucela. Landela njalo izincomo ezikhethekile zomhlinzeki wakho wezempilo.

Q5: Yini amathuba okuthi i-vaginal fistula ibuye ngemva kokuhlinzwa?

Amanani okuphindaphinda ngokuvamile aphansi lapho ukulungiswa kwe-fistula kwenziwa ochwepheshe abanolwazi. Amanani okuphumelela ngokuvamile ahlanganisa u-85-95% ngokulungiswa kokuqala. Izici ezithinta impumelelo zihlanganisa ukukhulu nendawo ye-fistula, impilo yakho yonke, nokuthi izimo ezingapheli njenge-inflammatory bowel disease zilawulwa kahle yini. Udokotela wakho uzoxoxa ngezici zakho zomuntu siqu ezingozi nemiphimisho elindelekile.