Call us directly: +44 (0) 30 0302 0202

Emmanuel Kaye House View Location

Mitrofanoff

 

The Mitrofanoff Procedure

This procedure is carried out where emptying of the bladder is not possible by the normal route (the urethra). It is frequently used in conjunction with other urological procedures where satisfactory voiding function may have been lost, such as bladder augmentation to ensure complete emptying of the bladder and protection of the upper urinary tract (kidneys).

The purpose of this operation is to form a channel between the bladder or urinary reservoir and the wall of the abdomen to allow intermittent self-catherisation.

The mitrofanoff channel (tube) is preferentially made from the appendix, which is mobilized on its blood supply. One end is tunneled through the wall of the bladder (or urinary reservoir) to create a valve, which squeezes shut as the bladder fills. This gives continence. The other end is passed through an incision in the abdominal wall to form a small stoma through which a catheter (small hollow tube) is passed to empty the bladder 4-6 times a day. In many cases the stoma is fashioned into the umbilicus (belly button) so is not visible to and cosmetically hidden. If it not possible to use the appendix then a small section of the small intestine may be rolled into a tube and used instead.

The stoma site can be situated in a number of places the Urinary Continence Nurses will discuss the favored position before the operation. The stoma is normally situated on the right hand side just below the underwear line, for cosmetic appearances another possible site is the umbilicus (belly button).

This is a major operation with an average stay in hospital of two weeks. To ensure drainage and allow complete healing one or two catheters may be left in place for up to 6 weeks. A second stay is then required to remove these catheters and to teach self catherterasation, and how to care for the Mitrofanoff stoma.

Advantages of the Mitrofanoff Procedure

Continence is archived, as urine will be stored in the bladder/reservoir until a catheter is inserted.

This is cosmetically more appealing than a standard urinary stoma, which drains continuously into a bag adherent to the skin ie no stoma bag, is required as is the case with other urinary diversion procedures.

Risks and complications of Bladder Augmentation Surgery

This is a complex surgical procedure for which specialist expertise and long term support is required. In this type of procedure revision surgery may be required to deal with:

Leakage from Mitrofanoff channel

Narrowing (scarring) of the Mitrofanoff channel

Hernias of the Mitrofanoff channel

Catheterisation increases the risk of urinary infection

Increased risk of urinary stones

Regular washouts of bowel mucus may be required

Increased risk of salt imbalance if larger bowel segments are required for bladder reconstruction

 

 

Getting help

If you wish to make an appointment to seek further advice and or treatment, please contact Mr Ockrim’s secretary.

Consultations

The information contained within this website has been provided as a general guide and should not be treated as a substitute for the medical advice of your own GP or any other health professional.