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Appendicovesicostomy for pubescent patients with neurogenic bladder using umbilicus as a stomal site
Akiko Uda1, Yutaro Hayashi, Yoshiyuki Kojima
1Department of Urology, Nagoya City University Medical School, Japan. akiuda@med.nagoya-cu.ac.jp
Insights
This study presents a surgical solution for persistent incontinence in neurogenic bladder patients. The Mitrofanoff Principle was used to create a catheterizable channel from the appendix to the umbilicus, improving bladder management.
Area of Science:
- Urology
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Neurogenic bladder often necessitates long-term management strategies.
- Clean intermittent catheterization (CIC) is a common treatment for neurogenic bladder.
- Persistent incontinence can significantly impact quality of life in affected individuals.
Observation:
- Two pediatric cases with neurogenic bladder experienced persistent incontinence despite long-term clean intermittent catheterization (CIC).
- Standard CIC protocols failed to achieve adequate bladder control and continence in these patients.
- The limitations of CIC highlighted the need for alternative management approaches.
Findings:
- The Mitrofanoff Principle was successfully applied in both cases.
- A catheterizable conduit was created using the appendix, extending to the umbilicus.
- This surgical reconstruction facilitated improved bladder emptying and continence.
Implications:
- The appendix can serve as a viable catheterizable conduit for managing complex neurogenic bladder cases.
- The Mitrofanoff procedure offers a potential solution for patients with refractory incontinence.
- This approach may enhance functional outcomes and quality of life for individuals with neurogenic bladder.
Abstract:
We experienced two cases of neurogenic bladder in which clean intermittent catheterization (CIC) had been performed since early childhood. In both cases, CIC had not provided adequate voiding control and incontinence persisted. According to the Mitrofanoff Principle, we used the appendix as a catheterizable conduit, which was constructed to the umbilicus.