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Purpose: Use of the Mitrofanoff principle is a valuable adjunct tomany reconstructive urological procedures in the pediatric age grouprequiring clean intermittent catheterization (CIC) especially if theurethra is not easily catheterizable. We present our experience with122 children and analyze the results of this operation. Materials andMethods: 133 Mitrofanoff channels (100 appendicular, 31 ureteric and 2Monti) were constructed in 122 children (93 boys and 29 girls) of meanage 6.3 years over the period from 1997 to 2005. The procedure was partof the reconstructive procedure in patients of neurogenic bladder(n=44), exstrophy-epispadias (n=40), posterior Urethral valve (n=30),and other diseases (n=8). Additional procedures included augmentationcystoplasty (n=90) and bladder neck procedure (n=46). Results: Meanfollow-up was 2.6 years in 109 patients. Overall results weresatisfactory. Major complication rates with the Mitrofanoff conduitusing appendicular and ureteric channels were 7.4 % in and 25.8%,respectively, most of the ureteric channels due to non-use, there beingalternate channels for catheterization. Only six (4.5%) childrenrequired re-operation for significant problems with the Mitrofanoffconduit: revision of stoma due to stenosis or kinking (n=4) and closureof stoma due to troublesome leak (n=2). Children and parents weresatisfied with the results of the operation and the majority wascompliant with regular CIC. All children were socially well acceptedand those above 6 years of age were attending regular school. Conclusions: The Mitrofanoff procedure is a feasible and acceptableoption, with a low complication rate, for use as part of complexurinary reconstruction in a developing country. Patient education,family motivation, and cost reduction are important factors forsuccess.

Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children