Utility of Mitrofanoff as bladder draining tool: A single center experience in pediatric patients

Özet

Objective: Mitrofanoff procedure has been employed commonly as bladder draining tool in patients unableto do clean intermittent self catheterization through native urethera. Single centre experience of pediatricage group patients undergoing Mitrofanoff procedure has been presented here.Material and methods: It was a retrospective study of 29 children who underwent continent catheterizableconduit (CCC), from January 2009 till March 2017. Charts were reviewed for age, gender, presenting complaints, need for augmentation cystoplasty, Mitrofanoff channel source such as appendix or ileal patch, duration of surgery in minutes, hospital stay in days, per operative and postoperative complications. Preoperativeevaluation of the children was done by doing complete blood picture, serum electrolytes, and renal functiontests. Radiological evaluation included ultrasound kidney,ureter and bladder, voiding cystourethrography,urodynamic analysis and a nuclear renal scan with 99m Technetium dimercapto-succinic acid or MAG-3scan. The abdominal end of the conduit was brought through the abdominal wall, and a stoma was fashionedby the V-quadrilateral-Z technique.Results: Twenty nine children having mean age of 9.54±4.88 years underwent CCC. There were 19 males(65.51%) and 10 females (34.48%). Children who underwent CCC included 18 children having neurogenicbladder, 2 cases of urethral trauma/stricture 3 patients with history of posterior uretheral valve and 6 patients with exstrophy bladder. Augmentation cystoplasty plus mitrofanoff was done in 18 children whileonly mitrofanoff in 11 children. Stuck catheter was seen in one patient which was removed successfullyvia normal urethral route under general anesthesia. Stomal stenosis in first year was noted in 4 patients(13.79%).Conclusion: Continent catheterizable conduit based on Mitrofanoff principle have durable outcome overlong term follow up in terms of urinary continence and complications.