Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children

<b>Purpose: </b> Use of the Mitrofanoff principle is a valuable adjunct to many reconstructive urological procedures in the pediatric age group requiring clean intermittent catheterization (CIC) especially if the urethra is not easily catheterizable. We present our experience with 122 ch...

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Main Authors: Sinha Shalini, Sen Sudipta, Chacko Jacob, Karl Sampath, Mathai John
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2006-01-01
Series:Journal of Indian Association of Pediatric Surgeons
Subjects:
Online Access:http://www.jiaps.com/article.asp?issn=0971-9261;year=2006;volume=11;issue=4;spage=218;epage=222;aulast=Sinha
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author Sinha Shalini
Sen Sudipta
Chacko Jacob
Karl Sampath
Mathai John
author_facet Sinha Shalini
Sen Sudipta
Chacko Jacob
Karl Sampath
Mathai John
author_sort Sinha Shalini
collection DOAJ
description <b>Purpose: </b> Use of the Mitrofanoff principle is a valuable adjunct to many reconstructive urological procedures in the pediatric age group requiring clean intermittent catheterization (CIC) especially if the urethra is not easily catheterizable. We present our experience with 122 children and analyze the results of this operation. <b> Materials and Methods: </b> 133 Mitrofanoff channels (100 appendicular, 31 ureteric and 2 Monti) were constructed in 122 children (93 boys and 29 girls) of mean age 6.3 years over the period from 1997 to 2005. The procedure was part of the reconstructive procedure in patients of neurogenic bladder (n=44), exstrophy-epispadias (n=40), posterior Urethral valve (n=30), and other diseases (n=8). Additional procedures included augmentation cystoplasty (n=90) and bladder neck procedure (n=46). <b> Results: </b> Mean follow-up was 2.6 years in 109 patients. Overall results were satisfactory. Major complication rates with the Mitrofanoff conduit using appendicular and ureteric channels were 7.4 &#x0025; in and 25.8&#x0025;, respectively, most of the ureteric channels due to non-use, there being alternate channels for catheterization. Only six (4.5&#x0025;) children required re-operation for significant problems with the Mitrofanoff conduit: revision of stoma due to stenosis or kinking (n=4) and closure of stoma due to troublesome leak (n=2). Children and parents were satisfied with the results of the operation and the majority was compliant with regular CIC. All children were socially well accepted and those above 6 years of age were attending regular school. <b> Conclusions: </b> The Mitrofanoff procedure is a feasible and acceptable option, with a low complication rate, for use as part of complex urinary reconstruction in a developing country. Patient education, family motivation, and cost reduction are important factors for success.
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spelling doaj.art-425e268c6e8546e88532ea13c5972ab02022-12-22T00:32:43ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92612006-01-01114218222Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 childrenSinha ShaliniSen SudiptaChacko JacobKarl SampathMathai John<b>Purpose: </b> Use of the Mitrofanoff principle is a valuable adjunct to many reconstructive urological procedures in the pediatric age group requiring clean intermittent catheterization (CIC) especially if the urethra is not easily catheterizable. We present our experience with 122 children and analyze the results of this operation. <b> Materials and Methods: </b> 133 Mitrofanoff channels (100 appendicular, 31 ureteric and 2 Monti) were constructed in 122 children (93 boys and 29 girls) of mean age 6.3 years over the period from 1997 to 2005. The procedure was part of the reconstructive procedure in patients of neurogenic bladder (n=44), exstrophy-epispadias (n=40), posterior Urethral valve (n=30), and other diseases (n=8). Additional procedures included augmentation cystoplasty (n=90) and bladder neck procedure (n=46). <b> Results: </b> Mean follow-up was 2.6 years in 109 patients. Overall results were satisfactory. Major complication rates with the Mitrofanoff conduit using appendicular and ureteric channels were 7.4 &#x0025; in and 25.8&#x0025;, respectively, most of the ureteric channels due to non-use, there being alternate channels for catheterization. Only six (4.5&#x0025;) children required re-operation for significant problems with the Mitrofanoff conduit: revision of stoma due to stenosis or kinking (n=4) and closure of stoma due to troublesome leak (n=2). Children and parents were satisfied with the results of the operation and the majority was compliant with regular CIC. All children were socially well accepted and those above 6 years of age were attending regular school. <b> Conclusions: </b> The Mitrofanoff procedure is a feasible and acceptable option, with a low complication rate, for use as part of complex urinary reconstruction in a developing country. Patient education, family motivation, and cost reduction are important factors for success.http://www.jiaps.com/article.asp?issn=0971-9261;year=2006;volume=11;issue=4;spage=218;epage=222;aulast=SinhaContinent urinary diversionMitrofanoff principle
spellingShingle Sinha Shalini
Sen Sudipta
Chacko Jacob
Karl Sampath
Mathai John
Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children
Journal of Indian Association of Pediatric Surgeons
Continent urinary diversion
Mitrofanoff principle
title Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children
title_full Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children
title_fullStr Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children
title_full_unstemmed Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children
title_short Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children
title_sort use of the mitrofanoff principle in urinary tract reconstruction experience with 122 children
topic Continent urinary diversion
Mitrofanoff principle
url http://www.jiaps.com/article.asp?issn=0971-9261;year=2006;volume=11;issue=4;spage=218;epage=222;aulast=Sinha
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AT karlsampath useofthemitrofanoffprincipleinurinarytractreconstructionexperiencewith122children
AT mathaijohn useofthemitrofanoffprincipleinurinarytractreconstructionexperiencewith122children