The Mitrofanoff urinary diversion for complex vesicovaginal fistulae: experience from Uganda

To evaluate the results of Mitrofanoff continent urinary diversion in a group of women with persistent severe incontinence after vesicovaginal fistula (VVF) secondary to obstructed labour.

Seven women with severe incontinence following a VVF were offered the Mitrofanoff procedure after all other attempts had failed to restore continence. In three patients a caecocystoplasty formed the urinary reservoir and in four the bladder was used. In all seven patients the appendix was used as the conduit for self-catheterization. The mean (range) follow-up was 10 (3-14) months.

One patient died postoperatively from hepatic failure, which could not be attributed to the particular procedure. One patient required re-operation at 10 days to adjust the conduit, but of the six patients who recovered, all are fully continent and self-catheterizing with no difficulty.

The Mitrofanoff procedure appears to be a valuable technique to restore continence in this difficult group of patients.