Mitrofanoff procedure (catheterisable urinary stoma)

What is this?

This is a procedure to create a channel (for catheterisation) between the skin and either the bladder or a urinary reservoir. This is likely to be done in conjunction with another procedure (either enlarging the bladder with a bowel patch or creating a urinary reservoir). This information sheet should be read in conjunction with the relevant information sheet for any other procedure.

What alternatives are there?

Use of a catheter via the urethra (water pipe) or a urinary stoma with a bag

What to expect before procedure

You will usually be admitted on the same day as your surgery or the day before. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and the Urology Nurse Practitioner. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be give a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy. You will be given an injection under the skin of a drug (Clexane) which, together with the help of elasticated stockings provided by the ward, will help prevent thrombosis (clots) in the veins of your legs.

What happens during the procedure?

A full general anaesthetic (where you will be asleep throughout the procedure) will be used. Appendix isolated on its own blood supply The channel will be created using the appendix, a short segment of small intestine (ileum) or a combination of both. It will be joined to the skin by a flap fashioned into a small pit, rather like a second umbilicus (navel).

After the procedure

You may experience discomfort for a few days after the procedure but painkillers will be given to you on the ward and, later, to take home. Absorbable stitches are normally used on the skin flap and these do not require removal. Abdomen with drains & catheters following completion of the procedure A catheter will be inserted into the channel (for about 3 weeks), together with one or two catheters into the bladder or urinary reservoir (also for up to 3 weeks), to promote drainage and to allow the suturing to heal up completely. You will probably be able to go home, once you are mobile, with the catheters in place, having been taught how to manage them. You will be re-admitted 3 weeks after the operation for removal of these catheters and to be taught how to pass a catheter into the Mitrofanoff stoma. The average hospital stay is 2 weeks.

Potential side effects