Published: 2020-03-21

A single centre 10-year experience of Mitrofanoffs procedure for varied indications with its outcome

Hemangi R. Athawale, Shivaji B. Mane, Natasha Vagheriya, Hussain Kotawala, Prathamesh More, Taha Daginawala


Background: To evaluate long term efficacy and complications of Mitrofanoffs procedure in patients with bladder dysfunction.

Methods: Authors retrospectively reviewed the medical records of 51 patients who underwent construction of a continent catherisable channel (mitrofanoffs and monti) from 2009 till 2019 in our institution. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.

Results: Mean age was 7 years and mean follow up was for 3 years. 27 patients were with neurogenic bladder and 24 with non-neurogenic bladder. The most common type of conduit was appendicovesicostomy (38) followed by illeal monti (12) and ureter (1). The most common stomal site was umbilicus (44) followed by right lower abdominal quadrant (6). Catherterizable conduit complications included stomal leakage in 3, mucosal prolapse at the stoma site in1 and an intra peritoneal leak requiring exploratory laprotomy and revision in1. Relative stomal continence was achieved in 98%. The preoperative serum creatinine & blood urea nitrogen (BUN) at the time of mitrofanoffs procedure at the last follow up after the procedure were sought and compared using Chi square test showed statistically significant improvement (p<0.01). No differences in outcome and complication rates were noted between different types of conduit, sites of implantation, or segments used for augmentation.

Conclusions: Mitrofanoff is a safe and reliable procedure in children who are dependent on intermittent catherisation in developing countries. Appendicovesicostomy is our first option followed by yang -monti illeovesicostomy.  While stomal continence is excellent patient education, family motivation and cost reduction are important factors for its lasting efficiency.


Continence, Developing countries, Mitrofanoffs procedure, Neurogenic bladder, Yang -monti illeovesicostomy

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Mitrofanoff P. Trans-appendicular continent cystostomy in the management of the neurogenic bladder. Chir Pediatr. 1980;21(4):297e305.

Kass EJ, Koff SA, Diokno AC, Lapides J. The significance of bacilluria in children on long-term intermittent catheterization. J Urol. 1981 Aug;126(2):223-5.

Furness PD, Malone PSJ, Barqawi A, Koyle MA. The Mitrofanoff principle. Innovative applications in continent urinary diversion. Contemp Urol. 2003;15(1):30-45.

Thomas JC, Dietrich MS, Trusler L, DeMarco RT, Pope JC, Brock JW, et al. Continent catheterizable channels and the timing of their complications. J Urol. 2006;176(4Pt 2):1816-20.

Narayanaswamy B, Wilcox DT, Cuckow PM Duffy PG, Ransley PG. The Yange Monti ileovesicostomy: a problematic channel? BJU Int. 2001;87(9):86-5.

Castellan MA, Gosalbez R, Labbie A, Ibrahim E, Disandro M. Outcomes of continent catheterizable stomas for urinary and fecal incontinence: comparison among different options. BJU Int. 2005;95(7):1053-7.

Piaggio L, Myers S, Figueroa TE, Barthold JS. González R. Influence of type of conduit and site of implantation on the outcome of continent catheterizable channels. J Pediatr Uro. 2007;3(3):230-4.

Franc-Guimond J, Gonzalez R. Effectiveness of implanting catheterizable channels into intestinal segments. J Pediatr Urol. 2006;2:31-3

Van Savage JG, Khoury AE, McLorie GA, Churchill BM. Outcome analysis of Mitrofanoff principle applications using appendix and ureter to umbilical and lower quadrant stomal sites. J Urol. 1996;156(5):1794.

Schlomer BJ, Copp HL. Cumulative incidence of outcomes and urologic procedures after augmentation cystoplasty. J Pediatr Urol. 2014;10:1043-50.

Singh P. Can baseline serum creatinine and e-GFR predict renal function outcome after augmentation cystoplasty in children? 2018;44(1):156-62.

Bhatti W, Sen S, Chacko J, Thomas G, Karl S, Mathai J, et al. Does bladder augmentation stabilize serum creatinine in urethral valve disease? A series of 19 cases. J Pediatr Urol. 2007 Apr 1;3(2):122-6.

William D, Leslie T, Eugene M, Paul M, David K, Deborah R, et al. Successful renal transplantation in children with posterior urethral valves. J Urol. 2003;170:2402-4.

Lopez Pereira P, Jaureguizar E, Martinez Urrutia MJ, Meseguer C, Navarro M. Does treatment of bladder dysfunction prior to renal transplant improve outcome in patients with posterior urethral valves?. Pediatr Transpl. 2000;4(2):118-22.

Sinha S, Sen S, Chacko J, Karl S, Mathai J. Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children. J Indian Assoc Pediatr Surg. 2006;11(4):218.

Leiard A, Seguier-Lipszyc E, Mathiot A, Mitrofanoff P. The Mitrofanoff procedure: 20 years later. J Urol. 2001;165:2394.

Fishwick JE, Gough DC, O’Flynn KJ. The Mitrofanoff procedure: does it last? BJU Int. 2000;85(4):496-7.