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SYMPOSIUM
Year : 2013  |  Volume : 29  |  Issue : 4  |  Page : 316-321

Reconstructing the lower urinary tract: The Mitrofanoff principle


Department of Urology, Freeman Hospital, High Heaton, Newcastle Upon Tyne, NE77DN, United Kingdom

Correspondence Address:
Rajan Veeratterapillay
Department of Urology, Freeman Hospital, High Heaton, Newcastle Upon Tyne, NE77DN
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.120113

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Since the original description of the trans-appendicular continent cystostomy by Mitrofanoff in 1980, a variety of techniques have been described for creating a continent catheterisable channel leading to the bladder, which avoids the native urethra. The Mitrofanoff principle involves the creation of a conduit going into a low pressure reservoir, which can emptied through clean intermittent catheterization through an easily accessible stoma. A variety of tissue segments have been used for creating the conduit, but the two popular options in current urological practice remain the appendix and Yang-Monti transverse ileal tube. The Mitrofanoff procedure has an early reoperation rate for bleeding, bowel obstruction, anastomotic leak or conduit breakdown of up to 8% and the most common long-term complication noted is stomal stenosis resulting in difficulty catheterizing the conduit. However, in both pediatric and adult setting, reports imply that the procedure is durable although it is associated with an overall re-operation rate of up to 32% in contemporary series. Initial reports of laparoscopic and robotic-assisted Mitrofanoff procedures are encouraging, but long-term outcomes are still awaited.


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