Appendicovesicostomy as an Alternative Procedure for Patients with Complex Urethral Distraction Defect

Area of Science:

• Urology
• Surgical reconstruction
• Urinary diversion

Background:

• Complex urethral strictures, particularly post-traumatic ones, present significant surgical challenges.
• Previous urethral reconstruction attempts often fail, leaving patients with limited treatment options.

Purpose of the Study:

• To evaluate the efficacy of the Mitrofanoff technique using the appendix as a conduit for urinary diversion in patients with irreparable urethral strictures.
• To assess the outcomes and continency in patients undergoing this procedure.

Main Methods:

• A retrospective study of six patients who underwent urinary diversion using an appendix between 2015 and 2019.
• All patients had a history of failed urethral reconstruction.
• Mean follow-up was 29 months, with continency defined as being dry for at least 3 hours.

Main Results:

• The mean age of patients was 40.1 years.
• Intermittent catheterization through the appendiceal conduit was easily performed in all patients without stomal stenosis.
• One patient experienced mild, transient stomal incontinence; all patients achieved daytime and nighttime continency.

Conclusions:

• The Mitrofanoff technique is a valuable and effective procedure for managing complex and irreparable urethral strictures.
• This approach provides a successful alternative for patients who have not responded to conventional treatments.