Mitrofanoff Continent Catheterizable Stoma for Pediatric Patients with Spinal Cord Injury

Our purpose was to determine the clinical efficacy of the Mitrofanoff catheterizable stoma for children and adolescents with spinal cord injury (SCI). In 1980, Mitrofanoff described the creation of an appendicovesicostomy for continent urinary diversion. This procedure greatly facilitates clean intermittent catheterization in patients with neurogenic bladder. We report on the objective results and the subjective measures of quality of life following appendicovesicostomy in 12 adolescents with SCI. Between 1996 and 1998, 12 adolescents with neurogenic bladders secondary to SCI underwent appendicovesicostomy formation, with or without bladder augmentation. Patients were interviewed about pre- and postoperative catheterization satisfaction. Infections, complications, and urinary continence were assessed postoperatively. Ten of twelve patients were satisfied with the procedure. Mean catheterization time was decreased from 16.4 to 5.1 min. Preoperatively, only 3 of 12 were able to perform self-catheterization, whereas all 12 were independent in catheterization postoperatively. Patient satisfaction preoperatively was 2.3 (scale 1-5) and improved to 4.5 postoperatively. Optimal management of the child with an SCI and neurogenic bladder is often clean intermittent catheterization. Unfortunately, many patients are unable to satisfactorily perform self-catheterization due to physical limitations. We report the successful use of the appendicovesicostomy continent catheterizable stoma in selected patients with SCI.