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The Mitrofanoff principle for urethral failure

C R Woodhouse¹, E M Gordon

¹Department of Urology, St George's Hospital, London, UK.

British Journal of Urology

|January 1, 1994

Summary

Surgery for urethral failure using Mitrofanoff principle achieved 94% continence in patients with lower urinary tract reconstruction. This supra-pubic diversion offers a preferable alternative to ileal conduits for complex cases.

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Area of Science:

Urology
Surgical Reconstruction

Background:

Urethral failure presents a significant challenge in lower urinary tract reconstruction.
Incontinence and chronic retention are common complications following initial reconstructive surgeries.
Previous attempts at reconstruction, including artificial sphincters, may fail.

Purpose of the Study:

To evaluate the surgical outcomes of continent supra-pubic diversion utilizing the Mitrofanoff principle for patients with urethral failure.
To assess the efficacy and safety of this reconstructive technique in a challenging patient cohort.

Main Methods:

Prospective data collection of patients undergoing lower urinary tract reconstruction.
Focus on 34 patients with urethral failure: 23 with incontinence and 11 with chronic retention.
Surgical intervention involved continent supra-pubic diversion (Mitrofanoff principle), with a novel detrusor tube technique in two cases.

Main Results:

High success rate with 94% of patients achieving continence.
Two patients achieved spontaneous voiding; the rest managed via self-catheterization.
A low complication rate of 17% with five minor revisions for catheterization ease.
One mortality reported in the study cohort.

Conclusions:

Continent supra-pubic diversion is a highly effective surgical option for urethral failure.
This method demonstrates superiority over ileal conduit formation in this difficult patient group.
The Mitrofanoff principle offers a reliable solution for achieving urinary continence and improving quality of life.

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