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The Mitrofanoff urinary diversion for complex vesicovaginal fistulae: experience from Uganda
Author(s) -
Kip Hodges
Publication year - 1999
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.1999.00197.x
Subject(s) - medicine , vesicovaginal fistula , clean intermittent catheterization , surgery , urinary incontinence , appendix , urinary diversion , urinary system , fistula , urinary bladder , bladder cancer , cystectomy , paleontology , cancer , biology
Objective To evaluate the results of Mitrofanoff continent urinary diversion in a group of women with persistent severe incontinence after vesicovaginal fistula (VVF) secondary to obstructed labour. Patients and methods Seven women with severe incontinence following a VVF were offered the Mitrofanoff procedure after all other attempts had failed to restore continence. In three patients a caecocystoplasty formed the urinary reservoir and in four the bladder was used. In all seven patients the appendix was used as the conduit for self‐catheterization. The mean (range) follow‐up was 10 (3–14) months. Results One patient died postoperatively from hepatic failure, which could not be attributed to the particular procedure. One patient required re‐operation at 10 days to adjust the conduit, but of the six patients who recovered, all are fully continent and self‐catheterizing with no difficulty. Conclusion The Mitrofanoff procedure appears to be a valuable technique to restore continence in this difficult group of patients.