Ingabe nawe uzwa ukuvuza komchamo kusuka kwenye indawo? Ake sifunde ngale fistula ye-urethrocutaneous!

Wake wazizwa sengathi uvuza umchamo usuka kwenye indawo engeyona evamile? Noma uthola izifo zomgudu womchamo ezivame ukwenzeka (UTIs)? Nakuba lezi yizinto ngezinye izikhathi esingazinaki kakhulu, isimo esiyisisekelo sibizwa ngokuthi i-Urethrocutaneous Fistula. Ungakhathazeki, sizoxoxa ngalokhu ngendlela elula ongayiqonda.

Iyini le fistula ye-urethrocutaneous?

Kalula nje, leli igama eliyinkimbinkimbi kancane, kodwa akunzima ukuliqonda. Ake siqale siqonde la magama.

• I-urethra: I-urethra yipayipi elithwala umchamo (obizwa nangokuthi umchamo ) liphuma emzimbeni wakho. Lifana nepayipi lamanzi.
• Isikhumba: Lokhu kubhekisela kokuthile okuhlobene nesikhumba .
• I-Fistula: I-fistula ukuxhumana okungajwayelekile, i-culvert, noma umhubhe phakathi kwezingxenye ezimbili zangaphakathi zomzimba noma phakathi kwengxenye yangaphakathi kanye nobuso besikhumba.

Bese kuthi i-urethrocutaneous fistula iyindlela entsha, engeyona eyemvelo eyakheka kusukela ku-urethra yakho iye esikhumbeni esizungeze izitho zakho zangasese noma isikhumba esiphakathi kwe-anus yakho nezitho zangasese (esikubiza ngezokwelapha ngokuthi i-perineum). Cabanga ngayo njengembobo epayipini lamanzi evuza amanzi evela kwenye indawo.

Ngokuvamile, umchamo kufanele udlule kuphela e-urethra bese uphuma emzimbeni. Kodwa ngenxa yale fistula, umchamo uqala ukudlula kuleyo ndlela entsha bese uphuma kuleyo mbobo entsha ebusweni besikhumba. Lokhu kubizwa nangokuthi i-urinary fistula noma i-urethral fistula .

Lesi simo sibhekwa njengesingathi sína ngoba ngeke siphole sodwa. Kuzodinga ukulungiswa ngokuhlinzwa nakanjani. Uma kungenjalo, kungaholela ekuthelelekeni okuvamile komgudu womchamo (UTIs) kanye nezinye izinkinga.

Ziyini izimpawu zalokhu? Wazi kanjani?

Kunezimpawu eziningana ezibalulekile ezingase zibonise ukuthi unalesi simo:

• Ukuvuza komchamo kusuka emgodini osanda kwakheka (i-fistula): Lolu uphawu oluyinhloko nolusobala kakhulu. Hhayi kuphela lapho uchama, kodwa ngezinye izikhathi ngisho nalapho umile. Lokhu sikubiza nangokuthi ukungalawuleki komchamo , okusho ukungakwazi ukulawula umchamo.
• Ukutheleleka okuvamile komgudu womchamo (UTIs): Le ndlela engeyona eyemvelo ivumela amagciwane ukuthi angene kalula emgudwini womchamo futhi abangele ukutheleleka. Lokhu kungalimaza nezitho nezicubu ezizungezile.

Uma unezimpawu ezinjengalezi, kungcono ukubonana nodokotela bese uyahlolwa.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Kunezizathu eziningana eziyinhloko zokuthi kungani kuvela i-fistula e-urethrocutaneous.

• Njengenkinga yokuhlinzwa kwangaphambilini: Lena yimbangela evame kakhulu. Lolu hlobo lwe-fistula lungavela, ikakhulukazi ngemva kokuhlinzwa kwesimo esibizwa ngokuthi i-hypospadias .
• Kuyini i-hypospadias? Kalula nje, yisimo abafana abazalwa naso. Kusho ukuthi imbobo yomchamo itholakala ngaphansi kwepenisi, hhayi esicongweni sepenisi. Ngakho-ke, ngemva kokuhlinzwa ukuze kulungiswe lokhu, i-fistula ngezinye izikhathi ingavela njengomphumela ongemuhle.
• Ukutheleleka: Ngezinye izikhathi, ngenxa yokutheleleka, ubomvu bungaqoqana ngaphakathi kwezicubu kuleyo ndawo bese kwakheka ithumba . Ngemva kokuba lobo bomvu selashwe futhi selaphekile, indlela encane efana nomsele ingasala ngaphakathi kwalezo zicubu. Yilokho okuba yi-fistula.
• Ukulimala: Lokhu kungenzeka ngenxa yokushaywa kanzima endaweni ethintekile. Isibonelo, ibhola le-mishit ngenkathi udlala ikhilikithi, i-puck emdlalweni ofana ne-hockey, noma ukuwela ebhakedeni eliwela umgwaqo (okuthiwa ukulimala kwe-straddle ) kungabangela lesi simo.
• Izimbangela ezingavamile: Akuvamile kakhulu ukuthi ezinye izingane zizalwe zinalesi simo. Futhi, abantu abanesifo sikashukela esingalawulwa kahle (okungukuthi, uma izinga labo le-HbA1c lingaphezu kuka-8% unyaka noma ngaphezulu, naphezu kokwelashwa okuvamile) basengozini yokuthola le fistula.

Yiziphi izinto ezibangela lokhu?

I-fistula ye-urethrocutaneous empeleni iyisimo esingavamile kakhulu. Kodwa-ke, ingozi enkulu yokuyithola ukuthi wake wahlinzwa ngaphambili e-urethra yakho.

Ngokwesibonelo:

• Ukuhlinzwa kokulungisa ama-hypospadia okukhulunywe ngawo ngaphambili.
• Ukwakhiwa kabusha kwe-urethra (ukwakhiwa kabusha kwe-urethra).
• Ukuhlinzwa okufana nokusoka .

Le fistula ngezinye izikhathi ingakhula njengenkinga ngemva kokuhlinzwa okunjalo.

Odokotela bakuthola kanjani lokhu? (Ukuxilongwa)

Uma unenkinga yokuvuza komchamo okungachazeki noma ukutheleleka komgudu womchamo okungachazeki, udokotela angase asole ukuthi une-fistula e-urethrocutaneous. Kunezivivinyo eziningana udokotela wakho angaziyala ukuqinisekisa ukuxilongwa:

• I-Voiding Cystourethrogram (VCUG): Kulolu vivinyo, udokotela ufaka idayi ekhethekile esinyeni sakho. Ngemuva kwalokho, ucelwa ukuthi uchame etafuleni lokuhlolwa. Udokotela angabe esebona ukuthi idayi iya kuphi nomchamo wakho nokuthi uyavuza noma kuphi.
• Ama-urethrogram noma ama-fistulogram abuyisela emuva: Lawa afana nama-VCUG. Afaka idayi esinyeni ukuze abone ngokucacile ukuthi ikuphi i-urethra, ikuphi i-fistula, nokuthi ixhumene kanjani.
• I-CT scan (i-Computed Tomography - i-CT scan): I-CT scan isebenzisa ama-X-ray kanye nobuchwepheshe bekhompyutha ukuthatha izithombe ezinemininingwane zangaphakathi lomzimba. Lokhu kungasiza odokotela ukuthi babone ukuthi kukhona yini ezinye izinkinga ezivela ku-fistula, njengethumba.
• I-Cystoscopy: Lokhu kuhilela ukufaka ithuluzi elide, elincane, elikhanyayo elibizwa ngokuthi i-cystoscope e-urethra yakho. Lokhu kuvumela udokotela ukuthi abone ngaphakathi kwe-urethra yakho futhi abone kahle ukuthi i-fistula ikuphi nokuthi ibukeka kanjani.

Yiziphi izindlela zokwelapha lokhu? Ingabe kungelapheka?

Yebo, lesi simo singelashwa. Ngokuvamile, sidinga ukuhlinzwa. Kodwa ngaphambi kokuqala ukwelashwa, udokotela uzocabangela izici eziningana. Nazi ezinye zazo:

• Usayizi we-fistula.
• Lapho itholakala khona (Indawo).
• Ingabe kukhona i-fistula engaphezu kweyodwa (Amathuba e-fistula eminingi) ?

Indlela yokwelapha inqunywa ngokusekelwe kulezi zici.

• Ama-fistula amancane (<2mm) kulula ukuwavala. Udokotela uzokunika umuthi wokudambisa ukuze akuphumuze futhi akwenze ulale, kanti udokotela ohlinzayo uzothunga i-fistula ivalwe.
• Ama-fistula amakhulu adinga ukuhlinzwa okuyinkimbinkimbi kakhulu. Ngezinye izikhathi, uma isikhumba esizungeze i-fistula singaphilile, udokotela ohlinzayo angadinga ukusebenzisa indlela enezingqimba eziningi. Lokhu kusho ukuthi isikhumba esinempilo esivela kwenye ingxenye yomzimba wakho (esibizwa ngokuthi ama-skin flaps ) siyathathwa ukuze sithathe indawo yezicubu ezonakele, bese kusetshenziswa ungqimba lokuvimbela amanzi ukuvala imbobo.

Abantu abaningi kuzodingeka basebenzise i-catheter yomchamo ukuze bakhiphe umchamo esinyeni sabo izinsuku ezimbalwa ngemva kokuhlinzwa. Lokhu kusiza indawo esanda kulungiswa ukuthi iphole. Ungase futhi udinge ukuhlala esibhedlela usuku olulodwa noma ngaphezulu ngemva kokuhlinzwa.

Ingabe le fistula izophola ngokwayo?

Cha, i-fistula ye-urethra ngeke iphole yodwa.Abantu abaningi nakanjani bazodinga ukuhlinzwa ukuze kuqedwe lokhu. Lokhu kungelashwa kuphela ngudokotela wezifo zomchamo , udokotela ogxile ezifweni ezihlobene nohlelo lomchamo kanye nohlelo lokuzala.

Kuthatha isikhathi esingakanani ukululama ngemva kokuhlinzwa?

Lokhu kunzima ukukusho ngokuqinisekile. Umzimba womuntu wonke uhlukile, ngakho-ke isikhathi sokuphulukiswa singahluka kumuntu nomuntu. Kodwa ngokuvamile, ukuvuvukala kanye nokulunywa okwenzeka ngemva kokuhlinzwa kuzophela emavikini ambalwa. Odokotela bathi kufanele uphulukiswe ngokuphelele emavikini ayisithupha . Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo phakathi naleso sikhathi.

Ingabe lesi simo singavinjelwa ukuthi singenzeki?

Eqinisweni, asikwazi ukuvimbela zonke izimbangela ezibangela ukuthuthukiswa kwe-fistula e-urethrocutaneous. Isibonelo, kunzima ngathi ukulawula eyodwa eba yinkinga yokuhlinzwa.

Noma kunjalo, ungenza lezi zinto ukuze uvimbele ukulimala kuleyo ndawo:

• Uma udlala ezemidlalo noma wenza eminye imisebenzi enzima, gqoka indebe yezemidlalo , eyaziwa nangokuthi i-jockstrap. Qiniseka ukuthi isayizi efanele wena.
• Gqoka ibhande lakho lesihlalo njalo uma ushayela noma njengomgibeli emotweni.
• Zivikele uma ugibela ibhayisikili. Uma kungenzeka, namathisela into efana ne-pannier rack ebhakeni elivundlile lebhayisikili lakho. Lokhu kungasiza ekunciphiseni ingozi yokulimala uma kwenzeka ingozi.

Kwenzekani uma ngine-fistula ephuma e-urethrocutaneous? Ingabe kufanele ngikhathazeke?

Kuvamile ukuzizwa wesaba kancane uma uthola ukuthi une-fistula ephuma e-urethrocutaneous. Kodwa ingxenye engcono kakhulu ukuthi, kunezindlela zokwelapha ngayo, futhi ngokwelashwa, izinga lokululama lilonke lihle kakhulu.

Ucwaningo olulodwa luthole ukuthi ukuhlinzwa kokulungisa i-fistula kuphumelele ngo-89%. Lokho kusho ukuthi kubantu abayishumi abahlinzwayo, cishe abayisishiyagalolunye bazolulama ngokuphelele. Ngezinye izikhathi, uma izimpawu ziqhubeka ngemva kokuhlinzwa kokuqala, kungenziwa indlela eyinkimbinkimbi kakhulu. Lokhu nakho kuyaphumelela kakhulu. Kodwa-ke, uma uhlinzwa okwesibili, kuzodingeka ulinde okungenani izinyanga eziyisithupha ngemva kokuhlinzwa kokuqala ukuze indawo iphole ngokuphelele.

Kufanele ngimbone nini udokotela?

Ngemva kokuhlinzwa ukuze kulungiswe i-urethrocutaneous fistula, kubaluleke kakhulu ukugcina ama-aphoyintimenti njalo nodokotela wakho ukuze uqiniseke ukuthi uphulukiswa kahle. Qiniseka ukuthi ugcina ama-aphoyintimenti akho njengoba udokotela wakho ekutshela. Ngale ndlela, angaqapha isimo sakho. Uma izimpawu zakho zisekhona, angancoma okunye ukuhlinzwa.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Ngemva kokuhlinzwa, uma unezinye zezimpawu ezilandelayo, kufanele uye eGumbini Eliphuthumayo eliseduze (ER) ngokushesha:

• Uma kukhona ukopha okukhulu endaweni yokuhlinzwa.
• Uma unomkhuhlane ongu-100 Fahrenheit (38 Celsius) noma ngaphezulu .
• Uma ubuhlungu bungaba nzima ukububekezelela .
• Uma unenkinga yokuchama, noma uma umchamo wakho ubonakala uvalekile.
• Uma kukhona igazi emchameni (i-Hematuria).

Futhi, uma i-catheter yakho iphuma yodwa, noma uma umchamo uvuza uzungeze i-catheter, kungcono ukubona udokotela ngokushesha.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela wakho?

Uma uya kudokotela wakho, unelungelo lokubuza imibuzo efana nale. Lokhu kuzokusiza ukuthi uqonde kangcono isimo sakho:

• Wazi kanjani ukuthi ngine-Urethrocutaneous Fistula?
• Yini eyayingabangela le fistula?
• Ingabe ngine-fistula encane noma enkulu?
• Ngingazinakekela kanjani ngesikhathi nginale fistula? Yini okufanele ngiyenze futhi yini okungafanele ngiyenze?
• Yiziphi izinkinga ezingaba khona ngenxa yalokhu kuhlinzwa kokulungisa i-fistula?
• Kulungile yini ukuya ocansini uma ngine-fistula ephuma e-urethrocutaneous? Ingabe lokho kuzodala inkinga?

Ungesabi ukubuza imibuzo efana nale. Udokotela wakho uzochaza konke kuwe.

Ekugcineni, umyalezo okufanele uwuthathe uye ekhaya:

Kulungile, manje sesikuqonda kahle lokho ebesikhuluma ngakho, i-Urethrocutaneous Fistula. Into ebaluleke kakhulu ukuthi uma unezimpawu ezinjengalezi, njengokuvuza komchamo kusuka kwenye indawo lapho uchama, noma uma une-UTI evame ukwenzeka, ungakushayi indiva. Ngezinye izikhathi kungaba yinto encane, kodwa kuhlale kuwukuhlakanipha ukufuna iseluleko sezokwelapha njengoba lokhu kungenzeka.

Khumbula, kukhona ukwelashwa kwalokhu, futhi ukwelashwa kungasebenza kahle. Ngakho-ke ungesabi noma ube namahloni okubona udokotela bese uxoxa ngezinto ezikukhathazayo. Sikufisela ukululama okusheshayo! Awuwedwa, futhi odokotela balapha ukuzokusiza.

I- Fistula ye-Urethrocutaneous, i-fistula yomchamo, ukuvuza komchamo, i-UTI, i-hypospadias, i-urethra, ukuhlinzwa, i-fistula yomchamo, ukuvuza komchamo, ukutheleleka kwendlela yomchamo