THE MITROFANOFF PRINCIPLE - EXPANDING UPON A VERSATILE TECHNIQUE

Objective To illustrate how the original principle of an appendicovesicostomy can be expanded upon and applied successfully to numerous urological conditions utilizing a variety of surgical techniques. Materials and methods Over the 8-year period 1985-1993 the Mitrofanoff principle was utilized 105 times in 100 consecutive patients. Seven different types of catheterizing conduit were constructed in conjunction with six varieties of urinary reservoir for patients falling into one of seven different categories of uropathy. Results At a median follow-up of 30 months, the continence rate for patients was 91%. The re-operation rate for conduit complications was 33%. Neither continence rates nor complications specific to the Mitrofanoff were related to the underlying uropathy, the type of conduit constructed, the urinary reservoir employed, and the patient's age at surgery. Conclusion The Mitrofanoff principle of continent urinary diversion is a versatile technique with a predictable success rate applicable to a wide variety of urological conditions. Patients and surgeons should be aware of the significant rates of revision required on the catheterizing conduit to enable continence to be ultimately achieved.