INTERMITTENT SELF-CATHETERIZATION BY QUADRIPLEGIC PATIENTS VIA A CATHETERIZABLE MITROFANOFF CHANNEL

Purpose: Neurogenic bladder due to cervical spinal cord injury is ofte n best managed by clean intermittent catheterization. Limited upper ex tremity function makes patients with quadriplegia dependent on caregiv ers for clean intermittent catheterization. The Mitrofanoff umbilical appendicovesicostomy provides easy access to the bladder in patients w ith all types of access difficulty. We evaluated the Mitrofanoff umbil ical appendicovesicostomy in 7 patients with quadriplegia. Materials a nd Methods: Four men and 3 women with cervical spinal cord injury unde rwent the Mitrofanoff umbilical appendicovesicostomy with appendix (5) or ileum (2). Results: All patients are continent and able to self-ca theterize via the umbilical stoma. In 1 patient with an ileal Mitrofan off umbilical appendicovesicostomy umbilical incontinence was repaired surgically and stomal stenosis developed in 1, which required stomal revision. All patients use the stoma regularly. Four patients have mov ed out of care facilities and are living more independently. Conclusio ns: The Mitrofanoff catheterizable channel is a valuable option for bl adder management in patients with quadriplegia. Clean intermittent sel f-catheterization allows these patients independent function and facil itates their return to productive lives outside care facilities.