[The Mitrofanoff principle in the lower urinary tract reconstruction]

Since its description in 1980, the Mitrofanoff principle has become a widely utilized and successful technique for the management of patients with a variety of urological disorders. We report our experience with this procedure in 12 patients (8 M, 4F). The age range was 3.5 years to 17 years (average 13y) and follow-up was from 6 months to 3 years (average 1.7y). Patients were classified in 2 groups: I. When this procedure was done because of the patient was unable to perform urethral catheterization (6p). II. Concomitant bladder neck transection and Mitrofanoff diversion (6p). The appendice was used in 8 p and ureter in 4. Bladder augmentation was performed with ureter in 2 p and colon sigmoid in 3. In 1p, ileocecal segment and in other colon + ileum, were used to replace the bladder. All patients catheterize the Mitrofanoff channel easily, there were no cases of stomal stenosis and the conduit was continent in all. We consider that Mitrofanoff principle is a very successful technique and it can be used as the primary continence mechanism or as an adjunct of major urinary tract reconstruction, to ensure complete bladder emptying, in patients unable to perform urethral catheterization.