Use of the appendix for a catheterization stoma in partial quadriplegics

Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff principle) is an excellent means of managing many patients with altered bladder function, especially those with good bladder volume and low pressure. Motivated patients unable to perform urethral catheterization because of paresis or other reasons now have a method of urinary diversion free of an appliance, though additional procedures may be necessary if bladder volume is low and/or bladder pressure is high. We no longer routinely perform appendectomy during bladder substitution or bladder augmentation procedures. By removing the appendix, we may be discarding an appendage that might prove useful should future urinary reconstruction procedures be required.