Mitrofanoff procedure: Difference between revisions
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{{Short description|Surgical procedure for urinary diversion}} | |||
{{Use dmy dates|date=October 2023}} | |||
== | == Overview == | ||
The '''Mitrofanoff procedure''' is a surgical technique used to create a continent urinary diversion. It is primarily used in patients who require an alternative method for bladder emptying due to [[neurogenic bladder]], [[bladder exstrophy]], or other conditions that impair normal urinary function. The procedure involves the creation of a conduit, typically using the [[appendix]], to connect the bladder to the abdominal wall, allowing catheterization through a stoma. | |||
[[File:Mitrofanoff.jpg|thumb|right|Diagram of the Mitrofanoff procedure]] | |||
The | == History == | ||
The procedure was first described by [[Paul Mitrofanoff]] in 1980. It was developed as a means to provide patients with a reliable and continent method of bladder management, particularly for those with [[spina bifida]] or other congenital abnormalities affecting the urinary tract. | |||
== | == Indications == | ||
The Mitrofanoff procedure is indicated for patients who: | |||
* Have difficulty with [[urinary incontinence]] | |||
* Require frequent [[catheterization]] | |||
* Have undergone previous bladder surgeries that affect normal voiding | |||
* Have conditions such as [[spinal cord injury]] or [[multiple sclerosis]] that impair bladder function | |||
The | == Surgical Technique == | ||
The procedure typically involves the following steps: | |||
== | === Creation of the Conduit === | ||
The [[appendix]] is most commonly used to create the conduit, although other tissues such as a segment of the [[ileum]] can be used if the appendix is unavailable. The chosen tissue is isolated and prepared to form a channel between the bladder and the skin surface. | |||
=== Formation of the Stoma === | |||
A small opening, or stoma, is created on the abdominal wall. This stoma serves as the entry point for catheterization. The conduit is tunneled subcutaneously to this stoma, ensuring that it remains continent when not in use. | |||
== | === Bladder Augmentation === | ||
In some cases, bladder augmentation may be performed concurrently to increase bladder capacity and reduce pressure. This is often done using a segment of the [[intestine]]. | |||
After the | == Postoperative Care == | ||
After the procedure, patients require education on self-catheterization through the stoma. Regular follow-up is necessary to monitor for complications such as [[urinary tract infection]], stoma stenosis, or conduit leakage. | |||
== | == Complications == | ||
Potential complications of the Mitrofanoff procedure include: | |||
* Stomal stenosis | |||
* Urinary tract infections | |||
* Leakage from the conduit | |||
* Formation of [[bladder stones]] | |||
* [[ | == Related pages == | ||
* [[Urinary diversion]] | |||
* [[Bladder augmentation]] | |||
* [[Neurogenic bladder]] | * [[Neurogenic bladder]] | ||
* [[Spina bifida]] | * [[Spina bifida]] | ||
[[Category:Urologic surgery]] | |||
[[Category:Urinary system]] | |||
Latest revision as of 11:05, 15 February 2025
Surgical procedure for urinary diversion
Overview[edit]
The Mitrofanoff procedure is a surgical technique used to create a continent urinary diversion. It is primarily used in patients who require an alternative method for bladder emptying due to neurogenic bladder, bladder exstrophy, or other conditions that impair normal urinary function. The procedure involves the creation of a conduit, typically using the appendix, to connect the bladder to the abdominal wall, allowing catheterization through a stoma.
History[edit]
The procedure was first described by Paul Mitrofanoff in 1980. It was developed as a means to provide patients with a reliable and continent method of bladder management, particularly for those with spina bifida or other congenital abnormalities affecting the urinary tract.
Indications[edit]
The Mitrofanoff procedure is indicated for patients who:
- Have difficulty with urinary incontinence
- Require frequent catheterization
- Have undergone previous bladder surgeries that affect normal voiding
- Have conditions such as spinal cord injury or multiple sclerosis that impair bladder function
Surgical Technique[edit]
The procedure typically involves the following steps:
Creation of the Conduit[edit]
The appendix is most commonly used to create the conduit, although other tissues such as a segment of the ileum can be used if the appendix is unavailable. The chosen tissue is isolated and prepared to form a channel between the bladder and the skin surface.
Formation of the Stoma[edit]
A small opening, or stoma, is created on the abdominal wall. This stoma serves as the entry point for catheterization. The conduit is tunneled subcutaneously to this stoma, ensuring that it remains continent when not in use.
Bladder Augmentation[edit]
In some cases, bladder augmentation may be performed concurrently to increase bladder capacity and reduce pressure. This is often done using a segment of the intestine.
Postoperative Care[edit]
After the procedure, patients require education on self-catheterization through the stoma. Regular follow-up is necessary to monitor for complications such as urinary tract infection, stoma stenosis, or conduit leakage.
Complications[edit]
Potential complications of the Mitrofanoff procedure include:
- Stomal stenosis
- Urinary tract infections
- Leakage from the conduit
- Formation of bladder stones
