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The fallow mitrofanoff.

L Harper1, O Dunand2, E Dobremez1

  • 1Department of Pediatric Surgery, Hopital des Enfants, Pellegrin, CHU Bordeaux, France.

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|April 2, 2019
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Summary
This summary is machine-generated.

A Mitrofanoff appendicovesicostomy allows for bladder drainage in children unable to perform clean intermittent catheterization (CIC). This approach provides a temporary solution, enabling CIC initiation later without further surgery and with no conduit complications.

Keywords:
AppendicovesicostomyBladder drainageCystostomy

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Area of Science:

  • Pediatric Urology
  • Surgical Innovation
  • Bladder Management

Background:

  • Severe congenital dysfunctional bladders necessitate bladder drainage to preserve renal function.
  • Clean intermittent catheterization (CIC) is ideal but challenging for pediatric patients or those with neurological impairment.
  • Alternative drainage methods have limited long-term efficacy.

Purpose of the Study:

  • To report the experience with a 'fallow' Mitrofanoff procedure in children.
  • This involves an appendicovesicostomy with a temporary indwelling catheter for delayed CIC initiation.

Main Methods:

  • Retrospective review of 10 pediatric patients undergoing Mitrofanoff appendicovesicostomy.
  • Patients had a ≥6-month delay before CIC implementation due to opposition.
  • An indwelling catheter allowed intermittent drainage until CIC was feasible.

Main Results:

  • 10 patients (median age 41 months) with posterior urethral valves or non-neurogenic neurogenic bladders were included.
  • A median 29.5-month delay preceded CIC initiation.
  • No stomal leakage or stenosis occurred during the fallow or CIC periods; 3 patients experienced febrile urinary tract infections.

Conclusions:

  • Appendicovesicostomy is a viable option for children needing bladder drainage when immediate CIC is not possible.
  • It serves as a temporary conduit, allowing for later CIC initiation without additional surgery.
  • This method avoids complications associated with the conduit when CIC is eventually implemented.