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The Mitrofanoff principle in continent urinary reconstruction
1Department of Urology, Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
The Urologic Clinics of North America
|December 10, 1997
Summary
Continent urinary diversion using the Mitrofanoff principle creates a catheterizable channel for managing urinary incontinence. This technique reconstructs a flap valve mechanism, mimicking nature for effective fluid control in adults and children.
Area of Science:
- Urology
- Surgical Innovation
- Reconstructive Surgery
Background:
- Continent urinary diversion is crucial for complex urinary tract pathologies.
- The Mitrofanoff principle offers a flap valve mechanism for controlled fluid flow.
- This technique reconstructs a competent ureterovesical junction analogue.
Purpose of the Study:
- To describe the application of the Mitrofanoff principle in creating continent urinary diversion.
- To highlight the versatility of the Mitrofanoff principle using various tissues.
- To explore its use in both urinary and fecal incontinence management.
Main Methods:
- Construction of a catheterizable channel utilizing the Mitrofanoff principle.
- Application of the principle to native bladders and intestinal reservoirs.
- Implantation of a channel into the cecum for fecal incontinence.
Main Results:
- Successful creation of continent urinary diversion in pediatric and adult patients.
- Effective continence mechanism achieved with native bladders and augmented reservoirs.
- Demonstrated utility in managing fecal incontinence in neurogenic bowel dysfunction.
Conclusions:
- The Mitrofanoff principle provides a reliable method for continent urinary diversion.
- This technique is adaptable for various reconstructive needs, including fecal management.
- It effectively addresses urinary incontinence when direct reconstruction is not feasible.