Aia kekahi pilina kūpono ʻole ma waena o kou anus a me kou vagina? (Rectovaginal Fistula) E kamaʻilio kākou e pili ana!

Ke manaʻo nei ʻoe i kekahi manawa aia kekahi mea ʻē a ʻoluʻolu ʻole paha i loko o kou wahi vaginal? Hiki ke hilahila iki ke kamaʻilio e pili ana, akā hiki nō hoʻi ke lilo i mea ʻeha. I kēia lā e kamaʻilio mākou e pili ana i kahi kumuhana koʻikoʻi iki, akā hiki ke lilo i mea nui no nā poʻe he nui. ʻO ia hoʻi, kahi pilina maʻamau ʻole ma waena o ka anus a me ka vaginal, kahi kūlana i kapa ʻia (Rectovaginal Fistula) ma nā ʻōlelo lapaʻau.

He aha kēia (Rectovaginal Fistula)? E hoʻomaopopo maʻalahi kākou!

ʻAe, e nānā kākou i kēia (Rectovaginal Fistula). I ka ʻōlelo maʻalahi, he lua hou kēia e like me ka paipu e hana ʻia ma waena o kou rectum - ka ʻāpana o kou ʻōpū nui (colon) e hele ana mai kou anus a i kou rectum - a me kou vagina. E noʻonoʻo e pili ana, ua kokoke loa kēia mau ʻōkana ʻelua kekahi i kekahi i loko o ke kino. ʻO ka maʻamau, ʻaʻohe pilina ma waena o nā mea ʻelua. Eia nō naʻe, inā no kekahi kumu e hōʻino ʻia ai ka ʻiʻo ma waena o kēia mau mea ʻelua a make, e hana ʻia kahi lua, a i ʻole e like me kā mākou e kapa nei , he fistula .

Ke hana ʻia kahi fistula ma kēia ʻano, hoʻomaka ka ʻōpala a me ke kinoea mai kou rectum e komo i loko o kou vagina. He kūlana ʻoluʻolu ʻole loa kēia. Hiki i kēia mau fistula ke hele mai i nā nui a me nā ʻano like ʻole. Hiki i kekahi ke liʻiliʻi, aʻo kekahi ke nui.

Hiki i kēia ʻano ke hōʻeha iā ʻoe a me ka paʻakikī i ka hana ʻana i nā hana o kēlā me kēia lā. Akā ʻo ka mea maikaʻi loa, hiki ke mālama ʻia, a i ka hapa nui o nā hihia, hiki ke ho'ōla ʻia me ke ʻoki kino. Ua mākaukau kāu hui lapaʻau e hāʻawi iā ʻoe i ka lāʻau a me nā ʻōlelo aʻoaʻo āu e pono ai.

Loaʻa iā ʻoe kēia mau hōʻailona? (Rectovaginal Fistula) Nā Hōʻailona Maʻamau

I kēia manawa, e nānā kākou i nā hōʻailona maʻamau o kēia maʻi (Rectovaginal Fistula). Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau mea, pono ʻoe e ʻike i ke kauka.

• He kahe ʻala ʻino mai ka ʻōpū: ʻO kēia ka mea mua a ka poʻe e ʻike ai.
• Ka hoʻokuʻu ʻana o ka vaginal a i ʻole ke kinoea: ʻO kēia ka hōʻailona nui a maopopo loa o kēia ʻano.
• ʻEha i ka wā o ka moekolohe (Dyspareunia): He pilikia kēia no nā poʻe he nui.
• ʻEha ʻāpana Pelvic: Hiki i kēia ke ʻeha mau loa ma ka ʻōpū haʻahaʻa.
• Ke kahe ʻana o ke koko mai ka rectum a i ʻole ka vagina: I kekahi manawa hiki ke ʻike ʻia kēia ʻano kahe koko.

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻoluʻolu e ʻike koke i ke kauka, no ka mea, hiki i kēia ʻano ke alakaʻi i nā pilikia hou aʻe inā ʻaʻole mālama ʻia.

No ke aha e hana ai kēia? (Rectovaginal Fistula) Nā kumu

Hoʻomaka pinepine ka fistula rectovaginal i ka wā e hōʻino ʻia ai a make ka ʻiʻo ma waena o ka vagina a me ka anus. ʻO kēia ka manawa e hana ʻia ai ka lua, a i ʻole fistula. Hiki ke ulu i loko o kekahi mau lā, a i ʻole hiki ke ulu mālie i loko o nā makahiki.

Aia kekahi mau kumu e hiki ai ke alakaʻi i ka ulu ʻana o ka Rectovaginal Fistula. E nānā kākou i ko lākou ʻano:

• Nā ʻeha i ka wā hānau keiki: ʻO kēia ke kumu nui o kēia ʻano. Hiki ke ulu aʻe kēia ʻano fistula i ka wā e haehae ʻia ai ka vagina (nā waimaka vaginal) a i ʻole ʻaʻole e ho'ōla pono kahi ʻeha episiotomy i ka wā hānau keiki. I kekahi manawa, ʻoi aku ka nui o kēia inā he paʻakikī iki ka hānau ʻana, a inā hoʻohana ʻia nā mea hana.
• Nā pilikia o ka diverticulitis: Inā loaʻa ka maʻi i nā ʻeke liʻiliʻi (diverticulum) e hana ana ma ka paia o kou kolona a hana i kahi abscess, hiki iā ia ke laha a hōʻino i ka paia o kou vagina, e hana ana i kahi fistula.
• Nā maʻi ʻōpū mumū (IBDs): ʻO nā maʻi e like me ka maʻi a Crohn a me ka ulcerative colitis hiki ke hōʻino i nā ʻiʻo o ka rectum a me ka vagina, e alakaʻi ana i ke kūkulu ʻia ʻana o nā fistulas.
• ʻO ke ʻoki ʻōpū a i ʻole ke ʻoki pelvic: ʻO kekahi mau ʻoki ʻana, e like me ka hysterectomy, hemorrhoidectomy, ʻoki J-pouch, a i ʻole ke ʻoki prolapse o ke kino pelvic, hiki ke hana i kahi fistula inā ua hōʻino ʻia ka rectum a i ʻole ka vagina, a inā ʻaʻole i ho'ōla pono nā ʻeha ma hope o ke ʻoki ʻana.
• Kanesa: Hiki i nā fistulas e like me kēia ke ulu aʻe ma muli o ke kanesa cervical a i ʻole ke kanesa colorectal. Kāhea mākou i kēia mau fistulas malignant .
• ʻO ka lāʻau lapaʻau radiation i ka ʻāpana pelvic: Ke hāʻawi ʻia ka lāʻau lapaʻau radiation no nā mea e like me ke kanesa, hiki iā ia ke hōʻeha lōʻihi i nā ʻiʻo ma ia wahi, e hōʻemi ana i ko lākou hiki ke ho'ōla, a me ke kumu o nā fistulas.
• ʻEha i ka wā moe kolohe a i ʻole mai kahi mea ʻē aʻe o waho: I kekahi manawa hiki ke ulu kahi fistula inā ua ʻeha nui ka vagina a i ʻole ka anus i ka wā moe kolohe, a inā paha i hoʻokomo ʻia kahi mea kūlohelohe ʻole i loko o ka vagina.
• Nā maʻi: ʻO nā maʻi o nā kelepa anal a i ʻole nā ​​​​kelepa Bartholin i kekahi manawa ke hana i nā fistulas.

He mea kākaʻikahi loa ka hānau ʻia ʻana o ke kanaka me ka fistula rectovaginal. Ua kapa ʻia kēia e nā kauka he RVF hānau .

He aha nā hopena ʻaoʻao e hiki mai ana o kēia?

Inā ʻaʻole mālama pono ʻia kahi fistula rectovaginal, hiki iā ia ke alakaʻi i nā ʻano pilikia like ʻole. ʻO ia ke kumu he mea nui e ʻimi i ke kōkua lapaʻau i ka wā e ʻike ʻia ai nā hōʻailona.

• ʻŌpū a maʻi paha: Hiki i kēia ke hoʻoweliweli i ke ola inā waiho ʻole ʻia.
• Hoʻi hou ʻana o ka fistula: I kekahi manawa hiki ke hoʻi hou kēia ʻano ma hope o ka mālama ʻana.
• Ka mumū a me ka maneʻo o ka vagina, vulva, perineum, a i ʻole anus.
• ʻO nā maʻi ʻōpū mimi pinepine (UTIs) a i ʻole vaginitis.

Ma waho aʻe o kēia mau ʻeha kino, hiki i ka Rectovaginal Fistula ke loaʻa ka hopena koʻikoʻi i kou olakino noʻonoʻo. Hiki i kēia ke hoʻoluhi iā ʻoe a hoʻokaʻawale ʻia e ka lehulehu. Inā manaʻo ʻoe i kēia ʻano, he mea nui e ʻimi i ke kōkua mai kahi loea olakino noʻonoʻo.

Pehea e ʻike ai ke kauka i kēia?

Ke hele ʻoe e ʻike i ke kauka, e nīnau mua ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino. A laila e hana lākou i kahi hoʻokolokolo kino a me kahi hoʻokolokolo pelvic.

ʻO ka mea aʻe, e kauoha lākou i kekahi mau hoʻokolohua kūikawā e hōʻoia inā he fistula rectovaginal kou, e ʻike i ke kumu (inā ʻaʻole ʻike pololei ʻia), a e hoʻoholo i ka nui o ka fistula.

ʻO kekahi o nā hoʻokolohua i hana ʻia no kēia kumu:

• Endoscopy: Hoʻohana ʻia nā hoʻāʻo e like me colposcopy a/a i ʻole proctosigmoidoscopy e ʻike i nā fistulas. Pili kēia i ke komo ʻana i kahi ʻōmole me kahi kāmela i loko o ka rectum.
• Hoʻokolokolo ʻana ma lalo o ka anesthesia: I kekahi manawa hiki ke anesthetized ʻia ʻoe e nānā pono i ka fistula.
• Helu Koko Piha (CBC) a me ka Urinalysis: E nānā no nā maʻi.
• MRI a i ʻole CT scan o ka ʻāpana pelvic: E kiʻi i nā kiʻi maopopo o ka vagina a me ka rectum.
• Biopsy: Inā he kānalua he maʻi kanesa paha kēia, e lawe ʻia kahi ʻāpana ʻiʻo a nānā ʻia.

He aha nā lāʻau lapaʻau? E ola mākou!

ʻEkolu mau mea nui e noʻonoʻo ai i ka wā e mālama ai i kahi fistula rectovaginal:

1. E mālama i ke kumu o ka fistula.

2. Ke mālama ʻana i ka fistula ponoʻī.

3. Ke mālama ʻana i nā hopena ʻaoʻao e pili ana.

E hui pū, ʻo ʻoe a me kāu kauka e hoʻoholo i ka hoʻolālā lapaʻau kūpono loa iā ʻoe.

ʻO ka maʻamau, hoʻomaka mua ʻia nā lāʻau lapaʻau ʻoki ʻole (conservative) no nā fistula liʻiliʻi. ʻO kēia mau mea:

• Nā lāʻau antibiotic no nā maʻi.
• Nā lāʻau lapaʻau no ke kūlana kumu (e.g., IBD).
• Nā mea hoʻohui fiber e hoʻonui ai i ka noho.
• Ka mālama ʻana i nā ʻeha a me ka debridement.

Eia nō naʻe, pono e hana ʻia ke ʻoki kino no nā wahine he nui e pani ai i kēia fistula.Aia kekahi mau ala e hana ai i ke ʻoki kino. No ka laʻana, hiki iā ʻoe ke hoʻohana i nā ʻiʻo mai kou kino ponoʻī a i ʻole nā ​​ʻiʻo i ulu ʻia i loko o kahi keʻena hoʻokolohua e pani i ka lua. Na kāu kauka e hoʻoholo i ke ʻano ʻoki kino kūpono loa no kou kūlana a e wehewehe iā ʻoe ma mua o ke ʻoki kino.

I kekahi manawa, inā nui loa a paʻakikī paha ka fistula, pono paha ʻoe e hana i kahi colostomy manawa pōkole . Pili kēia i ka hoʻōki ʻana i ke kahe ʻana o ka ʻōpala mai kou kolona a me ka rectum a hiki i ka wā e ola ai ka fistula, a me ka ʻae ʻana i ka ʻōpala e hōʻiliʻili i loko o kahi ʻeke ma o kahi puka liʻiliʻi (stoma) i hana ʻia i loko o kou ʻōpū. Pono ʻoe e hoʻololi pinepine i kēia ʻeke. Ma hope o ka ola ʻana o ka fistula, e hana hou ʻia ʻoe e hoʻopili hou i kou ʻōpū a pani i ka puka. He mea weliweli paha kēia, akā he manawa pōkole wale nō ia.

ʻEhia ka lōʻihi e ho'ōla ai?

I ka hapanui o nā hihia, hiki iā ʻoe ke hoʻi i nā hana maʻamau i loko o hoʻokahi a ʻelua paha pule ma hope o ke ʻoki ʻana. Eia nō naʻe, hiki ke hala i kekahi mau mahina no ka ho'ōla piha ʻana o ka fistula. ʻO ka manawa e pono ai no kou ho'ōla ʻana e pili ana i kekahi mau kumu, e like me ka nui o ka fistula a me ke ʻano o ke ʻoki ʻana.

Āhea ʻoe e pono ai e ʻike hou i ke kauka?

Ma hope o kou hoʻomaka ʻana i ka lāʻau lapaʻau a i ʻole ke ʻoki ʻana , pono ʻoe e ʻike i kāu kauka no nā manawa hoʻopaʻa e hōʻoia i ka ho'ōla pono ʻana o kou fistula. E haʻi koke i kāu kauka inā e ʻoi aku ka ʻino o kāu mau hōʻailona a i ʻole inā loaʻa iā ʻoe nā hōʻailona hou.

Hiki iā ʻoe ke nīnau i ke kauka i nā nīnau e like me kēia:

• He aha nā pilikia e hiki mai ana mai ke ʻoki ʻana?
• Pehea e mālama ai i ka fistula ma ka home?
• Aia kekahi mea hiki iaʻu ke hana e pale aku ai i ka hana hou ʻana o kahi fistula rectovaginal?
• Aia wau i ka pilikia no ka hoʻomohala ʻana i nā ʻano fistula vaginal ʻē aʻe?

He aha ka mea e hiki mai ana? E noho lana ka manaʻo!

Pili kāu wānana i kekahi mau kumu:

• Ka nui a me ke koʻikoʻi o ka RVF.
• ʻO (RVF) ke kumu.
• Kou olakino holoʻokoʻa.
• Ke ʻano o ka lāʻau lapaʻau a i ʻole ke ʻoki kino āu e loaʻa nei.

Ma keʻano laulā, ʻoi aku ka paʻakikī o ka mālama ʻana i nā RVF paʻakikī ma mua o nā mea maʻalahi. Pono paha ʻoe e hana i nā ʻoki kino he nui. Hiki i kāu kauka ke hāʻawi iā ʻoe i kahi manaʻo maikaʻi o ka mea e manaʻo ai ma muli o kou kūlana.

ʻAʻole paha ʻoe i lohe i kahi fistula ma mua. Akā ma hope o ka ʻike ʻana he hoʻokahi kāu (Rectovaginal Fistula), aia paha ia ma kou manaʻo. Hiki i kēia kūlana ke hoʻopilikia i kou ola o kēlā me kēia lā, a hiki i kou hilinaʻi iā ʻoe iho. Akā, e hoʻomanaʻo, hiki i ka lāʻau lapaʻau ke kōkua iā ʻoe e hoʻihoʻi i ka mana ma luna o kou kino. Eia naʻe, hiki ke lōʻihi ka manawa e ho'ōla ai. No laila, e kamaʻilio pinepine me kāu kauka a e ʻimi i kā lākou alakaʻi a me ke kākoʻo.

ʻO ka mea hope loa, e hoʻomanaʻo i kēia.

ʻOiai ke ʻano a mākou i kamaʻilio ai i kēia lā (Rectovaginal Fistula) he mea paʻakikī iki a paʻakikī hoʻi,ʻO ka mea nui loa, aia kahi lāʻau lapaʻau no kēia. Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​mai hilahila a makaʻu paha e ʻimi i ke aʻo lapaʻau. ʻO ka hoʻomaka ʻana i ka lāʻau lapaʻau i ka wā mua e hiki ke kōkua iā ʻoe e hoʻōla koke a pale i nā pilikia. ʻAʻole ʻoe hoʻokahi, a aia nā kauka a me nā limahana olakino e kōkua iā ʻoe. E kū i kēia me ka wiwo ʻole!

ʻO ka Rectovaginal Fistula, RVF, ka hoʻokuʻu ʻana o ka vaginal, ka ea vaginal, ke ʻoki kino, ke olakino wahine, rectum, vagina, ka mālama ʻana i ka fistula