Page 36 - CANADIAN URINARY DIVERSIONS POSITION STATEMENT

Mitrofanoff
A Mitrofanoff serves as an alternative route to catheterizing the bladder when the urethra
cannot be reliably used. It involves using the appendix to create a catheterizable conduit
between the urinary bladder and skin surface. The appendix is the most commonly used conduit
for a continent catheterizable channel (Mitrofanoff appendicovesicostomy). Others prefer
using a transversely retubularized small bowel segment as a channel (Yang-Monti or Casale
technique). It is applicable to paediatric populations. Less popular, the fallopian tubes, ureter,
and tubularized colonic or bladder flaps have also been described as alternatives for urinary
conduits. When medical management fails, bladder reconstruction with bowel (augmentation
ileocystoplasty) becomes the treatment of choice for these patients (e.g., neurogenic bladder
or exstrophy). In many cases, augmentation is performed concomitant with the creation of
a Mitrofanoff. 88

Figure 6 A healthy Mitrofanoff diversion

Note. Reproduced with permission of Andrew MacNeily

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