Application of Mitrofanoff procedure in pediatric lower urinary tract dysfunction
10.3760/cma.j.issn.1000-6702.2018.11.009
- VernacularTitle:可控性阑尾输出道尿流改道术在小儿下尿路功能障碍性疾病治疗中的应用效果
- Author:
Kai FU
1
;
Wen FU
;
Wei JIA
;
Guochang LIU
Author Information
1. 510120,广州市妇女儿童医疗中心小儿泌尿外科
- Keywords:
Lower urinary tract dysfunction;
Appendix conduit;
Urinary diversion;
Reservoir
- From:
Chinese Journal of Urology
2018;39(11):835-838
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the treatment effect with Mitrofanoff procedure in lower urinary tract of pediatric patients.Methods 9 patients conducted Mitrofanoff procedure from January 2014 to January 2018 in our center were analyzed retrospectively.There were 2 boys and 7 girls,age from 4 to 14 years old (7.3 years old in average).1 child was diagnosed as bladder exstrophy,4 children were neurogenic bladder,2 children were bladder tumor and the other 2 were urethral trauma.All patients were conducted Mitrofanoff procedure under general anesthesia,used appendix as the conduit,3 patients used their original bladder as reservoir,bladder augmentation was employed in 4 patients and ileal neobladder was employed in 2 patients to construct reservoir.The distal of appendix was inserted into submucosal of reservoior and the proximal end was connected to the umbilical or lower abdominal wall.Results The operations were all successfully completed without sever complications,the time spent was 176-210 min,190 min in average,hemorrhage amount 20-35 ml.Patients were followed up 15 to 50 months,the bladder capacity is 80 to 120 ml.Hydronephrosis was improved compared with pre-operative condition.4 children diagnosed with neurogenic bladder still suffered vesical ureteral reflux.All patients can conduct clean intermittent catheterization without difficulty.There was no leakage of urine from the stoma,while 2 patients showed leakage of urine from urethra when exercising,so we closed the bladder neck 6 month later.Conclusion Mitrofanoff procedure can be implied in children with end-staged lower urinary tract dysfunction due to nerogenic bladder,bladder tumor,bladder exstrophy,which makes intermittent catheterization become more convenient.
