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When regular urination is difficult or impossible, the Mitrofanoff procedure provides a reliable, controlled method for emptying the bladder. In order to facilitate easier self-catheterisation and better bladder management, it is frequently advised for individuals with neurogenic bladder, congenital urinary tract anomalies, bladder dysfunction, or urine incontinence.
If you experience bleeding, difficulties catheterising, urine leaks from the stoma, or infection symptoms like fever or abdominal pain, consult a physician. Additionally, if you experience chronic stoma discomfort, swelling, or unusual discharge, consult a physician, as these may indicate conditions requiring immediate attention.
To reduce the risk of infection, it is crucial to empty the intestines as much as possible prior to Mitrofanoff surgery. Usually, preparation entails:
- Before surgery, patients typically fast and only drink clear liquids.
- Cleaning your bowels as directed by your doctor
Under general anaesthesia, the Mitrofanoff technique is carried out. The appendix is removed during surgery and attached to a small abdominal orifice (stoma) at one end and the bladder at the other. To prevent urine leakage, a valve is formed at the junction of the ureteral orifice and the bladder. Ureteral stents may be utilised if necessary to guarantee appropriate urine flow from the kidneys, and a temporary catheter may be inserted to drain urine while the bladder recovers. Subsequently, dissolvable sutures are used to close the primary incision.
The average time for a Mitrofanoff procedure is three to six hours, but it can take longer if it is combined with other surgeries, such as bladder augmentation. After the procedure, patients must remain in the hospital for approximately six weeks to allow the channel to heal before resuming regular use.
- Stoma leakage
- Mucus buildup in the tunnel
- Electrolyte imbalance
- Bladder stones (calculi)
- Bleeding
- Infections
- Intestinal obstruction
- Need for revision surgery
- Reduces urinary leakage and incontinence by providing a controlled method for bladder emptying.
- Easier and more comfortable catheterisation through an abdominal opening instead of the urethra.
- Improves independence, as many patients can perform self-catheterisation.
- Suitable for children, including young children who can learn to catheterise themselves.
- Improved quality of life through better bladder management and continence control.
For a few weeks after surgery, patients may experience blood in the urine (hematuria) and painful bladder spasms. Pain relievers and medications to relax the bladder muscle are often prescribed to manage these symptoms.Around six weeks after the procedure, patients typically visit their healthcare provider to learn self-catheterisation through the stoma, which is essential for long-term bladder management and independence.
When it comes to enhancing bladder management and maintaining continence, the Mitrofanoff procedure has a high overall success rate, typically 70-90%. Although occasional adjustments may be required to resolve stoma or tunnel-related concerns, the majority of patients report improved independence and quality of life.
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+99Process Involved for Mitrofanoff Procedure
Diagnosis & Pre-Surgical Evaluation
- Urological evaluation, cystoscopy, imaging (CT/MRI/ultrasound), urine and blood tests
- Assessment of bladder and kidney function, overall health, and surgical fitness
Pre-Surgery Preparations
- Medication review, fasting, and bowel preparation if needed
- Stoma site marking and counselling on catheterisation and stoma care
- Discussion of surgical approach (open, laparoscopic, or robotic)
Procedure
- Removal of the appendix (or another suitable conduit)
- Creation of a catheterizable channel connecting the bladder to an abdominal stoma
- Formation of a valve at the bladder end to prevent urine leakage
- Placement of a temporary catheter to allow bladder healing and, if needed, ureteral stents to ensure urine flow
Post-Surgical Recovery
- Hospital stay with pain management and gradual return to fluids and diet
- Training in self-catheterisation through the stoma
- Monitoring for complications such as infections, stoma issues, or bladder spasms
Long-Term Follow-Up
- Regular visits to monitor kidney function, stoma health, and electrolyte levels (if irrigation is required)
- Ongoing catheterisation and stoma care guidance
- Severe bladder dysfunction
- Neurogenic bladder
- Congenital urinary tract abnormalities
- Radiation-damaged bladder
- Chronic bladder disease
- Risk of progressive kidney damage
- Patients with severe bladder dysfunction not manageable with medications or less invasive treatments
- Individuals with a neurogenic bladder, causing unsafe urine storage, infections, or kidney damage
- Patients with congenital urinary tract abnormalities affecting normal urine flow
- Individuals with a radiation-damaged bladder leading to poor capacity or incontinence
- Patients with chronic bladder disease for whom other treatments have failed
- Individuals at risk of kidney damage due to impaired urine drainage
- Patients medically fit for surgery who can perform or receive long-term catheterisation through the stoma
- Bladder augmentation (cystoplasty)
- Appendectomy or use of other conduits
- Ureteral reimplantation
- Stoma creation
- Temporary catheter or suprapubic tube placement
- Correction of urethral or bladder anomalies
- Reliable bladder emptying via a stoma that can be catheterised
- Decreased leaking and incontinence of the urine
- Easier self-catheterisation leads to increased independence and quality of life.
- Improved kidney function protection through safe urine drainage
- Long-term efficacy when catheterisation and stoma care are appropriately maintained
- Ability for children and adults to manage bladder emptying independently or with minimal assistance
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