Mitrofanoff Principle for Continent Urinary Diversion

Ramanan, Venkat; Kapoor, Rakesh; Srinadh, E.S.; Babu, Ramesh; Rajan, Rajesh; Kumar, Anant

doi:10.1159/000282961

Cited by 14 publications

(2 citation statements)

References 9 publications

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“…Although our continence rate of 85.7 % (36/42) seems similar to other series, there are series in which continence rates are reported to be as high as 98% (4,15,19). The majority of our incontinent patients belong to the exstrophy-epispadias group of patients and the difference between continence rates can be explained by the nature of the diseases for which the procedure was performed.…”

Section: Discussionsupporting

confidence: 85%

Catheterisable Continent Urinary Diversion (Mitrofanoff Principle) - Clinical Experience and Psychological Aspects

Tekant

Emir²,

Eroğlu³

et al. 2001

Eur J Pediatr Surg

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48 Mitrofanoff principles (MTR) were performed on 46 patients (male : female ratio, 30 : 16) with a mean age of 9.1 years (range 2.5 to 24 years). The primary diagnoses were neurogenic bladder in 11, infravesical obstruction in 7 and bladder exstrophy-epispadias complex in 28 patients. The most common type of conduit was appendix (38 cases); other conduits were constructed from the ileum (seven) and ileocaecum (one). In two cases with bladder substitution the uterine tube and tubularised bladder stump were used as perineal MTR. 33 of the 46 children underwent augmentation cystoplasty in conjunction with the MTR procedure. The Malone procedure for antegrade colonic enema (ACE) was performed at the same stage with MTR in eight cases. To achieve continence, bladder neck reconstruction was performed in 32 patients and the bladder neck was closed in four patients during the same operation and MTR procedure. The mean follow-up period was 28.7 months (range one month to 57 months). To assess the psychological aspects of the MTR procedure, the Rosenberg Self-Esteem Scales were completed by 12 children older than eight years of age. Nine patients had problems with the MTR (19.5 %). Three appendiceal MTR had strictures at the skin level, 2 of which needed minor surgical revisions. A mucocele formation at the skin level of an appendix was removed successfully. We did not observe any complaints among the other appendiceal conduits. All the tapered ileum conduits were difficult to catheterise, and 1 of them had a leakage from the stoma. None of the three transversely tubularised ileum MTRs had problems with catheterisation or leakage. A stricture of the conduit from the uterine tube was observed. 36 of the 42 patients are now continent, giving a ratio of 86 %. The results of the Rosenberg Self-Esteem Scales revealed that there was an increase in the percentage of patients with high self-esteem, and a decrease in depressive feelings after the MTR procedure. We conclude that the MTR procedure provides excellent continence, offers good prospects of a socially acceptable life with increased self-esteem, and the appendix seems to be the ideal organ for continent urinary diversion, with the transverse tubularised ileal tube as a second choice.

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Section: Discussionsupporting

confidence: 85%

Catheterisable Continent Urinary Diversion (Mitrofanoff Principle) - Clinical Experience and Psychological Aspects

Tekant

Emir²,

Eroğlu³

et al. 2001

Eur J Pediatr Surg

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“…Despite all the modifications of the technique, CUD with the Mitrofanoff principle remains a complex procedure with a significant non-negligible complication rate (14). This surgical reconstruction technique has been described for pediatric and adult patients (15).…”

Section: Discussionmentioning

confidence: 99%

Self-perception, quality of life and ease of catheterization in patients with continent urinary diversion with the mitrofanoff principle

et al. 2020

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Purpose: Continent urinary diversion (CUD) with the Mitrofanoff principle stands as an alternative to urethral catheterization by a route other than the urethra. The aim of the study was to determine self-perception of health-related quality of life (HRQoL), ease of catheterization and global and cosmetic outcomes in patient’s dependent on Mitrofanoff catheterization. Materials and methods: Records of all patients who underwent CUD with the Mitrofanoff principle between 2012 to 2018 were reviewed. Data were collected and analysed retrospectively from medical charts. We assessed HRQoL with the EuroQol EQ-5D-3L questionnaire, cosmetic and global satisfaction with a questionnaire designed by the reconstructive urology board and ease of catheterization with a Likert questionnaire adapted from the Intermittent Catheterization Difficulty Questionnaire (ICDQ) validated in patients reliant on retrograde CIC. Results: A total of 25 patients requiring CUD with the Mitrofanoff principle between 2012 and 2018 were assessed, the group was composed mainly of: appendiceal conduits 18 patients (72%) and 7 ileal conduits (Yang-Monti) and three of those requiring Casale (Monti Spiral) and 1 a double Monti technique. Median follow-up was 57 months, median age was 30 years. Visual Analogue Scale (VAS) of the EQ-5D-3L reported a Global health score of 86.5%. Fifty nine percent of the patients had no pain or bleeding with catheterizations. Regarding global satisfaction and cosmetic perception 91% were satisfied with their CUD. Conclusions: CUD is associated with good HRQoL, global satisfaction, ease and painless catheterization, adequate self-perception of cosmetic outcomes and a low complication rate, remaining a safe and viable option.

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Les agrandissements vésicaux et dérivations

Thomas

Leval

2011

Les Incontinences Urinaires De L’homme

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Mitrofanoff Principle for Continent Urinary Diversion

Cited by 14 publications

References 9 publications

Catheterisable Continent Urinary Diversion (Mitrofanoff Principle) - Clinical Experience and Psychological Aspects

Catheterisable Continent Urinary Diversion (Mitrofanoff Principle) - Clinical Experience and Psychological Aspects

Self-perception, quality of life and ease of catheterization in patients with continent urinary diversion with the mitrofanoff principle

Les agrandissements vésicaux et dérivations

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