Kodi Rectovaginal Fistula ndi Momwe Imachiritsidwira?

Zamkati

• Zizindikiro zake ndi ziti?
• Nchiyani chimapangitsa izi kuchitika?
• Ndani ali pachiwopsezo chowonjezeka?
• Kodi amapezeka bwanji?
• Amachizidwa bwanji?
• Kodi zingayambitse mavuto otani?
• Momwe mungasamalire vutoli
• Chiwonetsero

Chidule

Fistula ndikulumikizana kwachilendo pakati pa ziwalo ziwiri. Pankhani ya fistula ya rectovaginal, kulumikizana kuli pakati pa rectum ya mkazi ndi nyini. Kutsegulira kumalola chopondapo ndi mpweya kutuluka kuchokera m'matumbo kupita kumaliseche.

Kuvulala pobereka kapena kuchitidwa opaleshoni kumatha kubweretsa vutoli.

Fistula yotchedwa rectovaginal fistula imatha kukhala yovuta, koma imachiritsidwa ndi opareshoni.

Zizindikiro zake ndi ziti?

Rectovaginal fistula imatha kuyambitsa zizindikilo zosiyanasiyana:

• chopondapo kapena mpweya kuchokera kumaliseche kwanu
• zovuta kuwongolera matumbo
• kutulutsa konyansa kumaliseche kwako
• mobwerezabwereza nyini matenda
• kupweteka kumaliseche kapena malo apakati pa nyini ndi anus (perineum)
• zowawa panthawi yogonana

Ngati muli ndi izi, onani dokotala wanu.

Nchiyani chimapangitsa izi kuchitika?

Zomwe zimayambitsa matenda a rectovaginal fistula ndi awa:

• Zovuta panthawi yobereka. Pakubereka kwanthawi yayitali kapena kovuta, perineum imatha kung'amba, kapena dokotala atha kudula mu perineum (episiotomy) kuti apereke mwanayo.
• Matenda otupa (IBD). Matenda a Crohn ndi ulcerative colitis ndi mitundu ya IBD. Amayambitsa kutupa m'mimba. Nthawi zambiri, izi zitha kukulitsa chiopsezo chotenga fistula.
• Khansa kapena radiation kumimba. Khansara kumaliseche kwanu, chiberekero, rectum, chiberekero, kapena anus zingayambitse fistula ya rectovaginal. Kutentha kwa khansa kungapangitsenso fistula.
• Opaleshoni. Kuchita opaleshoni kumaliseche kwanu, rectum, perineum, kapena anus kumatha kuvulaza kapena matenda omwe amatsogolera kukutseguka kwachilendo.

Zina mwazomwe zingayambitse ndi izi:

• kachilombo mu anus kapena rectum yanu
• matumba omwe ali ndi kachilombo m'matumbo mwako (diverticulitis)
• chopondapo chokhazikika mu rectum (fecal impaction)
• matenda opatsirana chifukwa cha HIV
• kugwiriridwa

Ndani ali pachiwopsezo chowonjezeka?

Mutha kukhala ndi kachilombo koyambitsa matendawa ngati:

• unagwira ntchito yayitali komanso yovuta
• perineum kapena nyini yanu inang'ambika kapena inadulidwa ndi episiotomy panthawi yobereka
• muli ndi matenda a Crohn kapena ulcerative colitis
• muli ndi matenda monga abscess kapena diverticulitis
• mwakhala ndi khansa ya kumaliseche, chiberekero, rectum, chiberekero, kapena anus, kapena radiation kuti muchepetse khansa iyi
• munachitidwa opaleshoni kapena opaleshoni ina m'chiuno

Pafupifupi azimayi omwe amabeleka kumaliseche padziko lonse lapansi amakhala ndi vutoli. Komabe, ndizochepa kwambiri m'maiko otukuka monga United States. Mpaka kwa anthu omwe ali ndi matenda a Crohn amakhala ndi rectovaginal fistula.

Kodi amapezeka bwanji?

Rectovaginal fistula imatha kukhala yovuta kuyankhula. Komabe ndikofunikira kuuza dokotala wanu za matenda anu kuti muthe kulandira chithandizo.

Dokotala wanu adzakufunsani kaye za matenda anu ndikuwunika. Ndi dzanja lokutidwa, adokotala amayang'ana kumaliseche kwanu, anus, ndi perineum. Chida chotchedwa speculum chitha kulowetsedwa kumaliseche kwanu kuti chimatsegule kuti dokotala wanu athe kuwona malowo bwino. Proctoscope imatha kuthandiza dokotala kuwona mu anus ndi rectum yanu.

Mayeso omwe dokotala angagwiritse ntchito kuti athandizire kupeza matenda a rectovaginal fistula ndi awa:

• Anorectal kapena transvaginal ultrasound. Pakuyesa uku, chida chofanana ndi mkombero chimalowetsedwa mu anus ndi rectum, kapena kumaliseche kwanu. Ultrasound imagwiritsa ntchito mafunde akumveka kuti apange chithunzi kuchokera mkati mwanu.
• Mankhwala a methylene. Chingwe chimalowetsedwa mumaliseche anu. Kenako, utoto wabuluu umalowetsedwa mu rectum yanu. Pambuyo pa mphindi 15 mpaka 20, ngati tampon itembenukira buluu, muli ndi fistula.
• Enema wa Barium. Mupeza utoto wosiyanasiyana womwe umathandizira dokotala wanu kuwona fistula pa X-ray.
• Kusanthula kwa kompyuta ya tomography (CT). Mayesowa amagwiritsa ntchito ma X-ray amphamvu kuti apange zithunzi mwatsatanetsatane m'chiuno mwanu.
• Kujambula kwa maginito (MRI). Kuyesaku kumagwiritsa ntchito maginito amphamvu ndi mafunde a wailesi kuti apange zithunzi kuchokera m'chiuno mwanu. Ikhoza kuwonetsa fistula kapena mavuto ena ndi ziwalo zanu, monga chotupa.

Amachizidwa bwanji?

Chithandizo chachikulu cha fistula ndi opaleshoni kutseka kutseguka kwachilendo. Komabe, simungathe kuchitidwa opaleshoni ngati muli ndi matenda kapena kutupa. Matenda oyandikana ndi fistula amafunika kuchiritsa kaye.

Dokotala wanu angakuuzeni kuti mudikire miyezi itatu kapena isanu ndi umodzi kuti matenda achiritse, ndikuwona ngati fistula yatseka yokha. Mupeza maantibayotiki othandizira matenda kapena infliximab (Remicade) kuti muchepetse kutupa ngati muli ndi matenda a Crohn.

Opaleshoni ya Rectovaginal fistula itha kuchitidwa kudzera m'mimba mwanu, kumaliseche, kapena perineum. Pakati pa opaleshoni, dokotala wanu amatenga chidutswa cha minofu kuchokera kwinakwake mthupi lanu ndikupanga chovala kapena pulagi kuti mutseke kutsegula. Dokotalayo adzakonzanso minofu ya anal sphincter ngati yawonongeka.

Amayi ena amafunikira colostomy. Kuchita opaleshonoku kumapangitsa kutsegula kotchedwa stoma m'mimba mwanu. Mapeto a matumbo anu akulu amatsegulidwa. Chikwama chimasonkhanitsa zinyalala mpaka fistula itachira.

Mutha kupita kunyumba tsiku lomwelo ndi opaleshoni yanu. Kwa mitundu ina ya opareshoni, muyenera kugona usiku wonse kuchipatala.

Zowopsa zochitikazo ndi monga:

• magazi
• matenda
• kuwonongeka kwa chikhodzodzo, ureters, kapena matumbo
• magazi m'mapazi kapena m'mapapu
• kutsekeka m'matumbo
• zipsera

Kodi zingayambitse mavuto otani?

Rectovaginal fistula imatha kukhudza moyo wanu wogonana. Zovuta zina ndizo:

• kuvuta kuwongolera gawo la chopondapo (chimbudzi)
• mobwerezabwereza thirakiti kapena matenda ukazi
• kutupa kwa nyini kapena perineum yanu
• chironda chodzaza mafinya (abscess) mu fistula
• fistula wina atalandira chithandizo choyamba

Momwe mungasamalire vutoli

Mukamadikirira kuti muchitidwe opareshoni, tsatirani malangizowa kuti muzimva bwino:

• Tengani maantibayotiki kapena mankhwala ena omwe dokotala wakupatsani.
• Sungani malowo moyera. Sambani kumaliseche kwanu mofatsa ndi madzi ofunda mukadutsa chopondapo kapena zotuluka zoipa. Gwiritsani ntchito sopo wofatsa, wopanda tsabola. Pat malowa ndi owuma.
• Gwiritsani ntchito zopukutira zopanda mafuta m'malo mwa mapepala achimbudzi mukamagwiritsa ntchito bafa.
• Ikani mafuta a talcum kapena kirimu chotchinga chinyezi kuti muteteze mkwiyo wanu kumaliseche ndi m'matumbo.
• Valani zovala zomasuka, zopumira kuchokera ku thonje kapena nsalu zina zachilengedwe.
• Ngati mukuthira ndowe, valani kabudula wamkati kapena thewera wamkulu kuti asataye ndowe pakhungu lanu.

Chiwonetsero

Nthawi zina fistula yotsekemera imadzitsekera yokha. Nthawi zambiri, opareshoni amafunikira kuti athetse vutoli.

Zomwe zimachitika pakuchita opareshoni zimadalira mtundu wa njira zomwe muli nazo. Kuchita opaleshoni yam'mimba kumakhala kopambana kwambiri, pa. Kuchita opaleshoni kudzera mu nyini kapena m'matumbo kumachita bwino. Ngati opaleshoni yoyamba sikugwira ntchito, mudzafunika njira ina.