THE MITROFANOFF PRINCIPLE IN URINARY RECONSTRUCTION

We report the use of the Mitrofanoff principle to achieve urinary cont inence in 47 patients. A catheterizable channel can be used as the pri mary continence mechanism, or as an adjunct to ensure complete bladder emptying if urethral catheterization or voiding is inadequate. Append ico-vesicostomy was performed in 25 of 47 patients (55%). Satisfactory continence was achieved in 45 patients (96%). Bladder emptying by cle an intermittent catheterization was performed in all patients. Early c omplications included peristomal abscess (1 patient) and small bowel o bstruction (1). Late complications included difficulty with catheteriz ation (5 patients), stomal stenosis (9) and persistent incontinence (2 ). Our results support use of the appendix as the catheterizable segme nt of choice. We describe the technique and discuss the management of complications.