, also known as the Mitrofanoff procedure
, is a surgical procedure
in which the appendix
is used to create a conduit between the skin surface and the urinary bladder
Description of procedure
In the procedure, the surgeon
separates the appendix from its attachment to the cecum
, while maintaining its blood supply
. Then she or he creates an opening at its blind end and washes it. One end is connected by sutures
to the urinary bladder and the other is connected to the skin to form a stoma
Generally, an incision is made into the umbilicus
(belly button) so that it may serve as the canal for the catheter.
Urine is typically drained several times a day by use of a catheter inserted into the Mitrofanoff canal.
The procedure is typically performed when there is a blockage of the normal outlet (as in urethral cancer
) or when there is a need for frequent, often uncomfortable, catheterizations
(as in neurogenic bladder
The most common patients who undergo this procedure are those who are dependent on catherization to eliminate urine, such as paraplegic individuals (typically those born with spina bifida). The Mitrofanoff procedure allows the individual to self-cath so that he or she is not dependent on a family member or a medical professional to catherize him or her.
The Mitrofanoff procedure has been found to improve the life of people with spinal cord injuries, by increasing their independence.
Relation to MACE
The Malone antegrade continence enema
(MACE), used to treat fecal incontinence
, is like the Mitrofanoff procedure as it uses the Mitrofanoff principle
and, thus, can be considered an analogous procedure.
As fecal and urinary incontinence frequency co-exist, a MACE is often created at the same time as a continent catheterizable urinary conduit.
Relation to Monti procedure
If the vermiform appendix
is not available, due to appendectomy
, or unusable for another reason, the Monti procedure