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Subject Area

Urology

Article Type

Original Study

Abstract

Objectives: To evaluate the success and complications associated with using the appendix as stoma in mitrofanoff procedure in a pediatric age group. Background: The management of bladder dysfunction may face many challenges and complications for preservation of continence. Methods: This was a prospective study that was conducted between January 2020 to January 2022 at Menoufia university hospital and Alexandria university hospital. The study included 30 patients (18 male and 12 female). The average surgical age at surgery was (5-15years). The mean follow up was for 6 months. Nineteen of the 30 patients underwent augmentation cystoplasty using ileum in conjunction with mitrofanoff procedure, and eleven patients had only continent catheterizable stoma. All patients underwent appendicovesicostomy. The reasons for mitrofanoff procedure was posterior urethral valve in 12 patients, spina bifida in 10 patients, bladder exstrophy complex in 2 patients and complex urethral stricture in 6 patients. Results: There were no complications in 22 cases (73.3%). There was one case (3.3%) with stomal stenosis. Urinary tract infection (UTI) was reported in 3 cases (10%). Incontinence was reported in one case (3.3%) and the patient refused any intervention. Prolapse of the stoma in one case (3.3%) requires revision of stoma. Difficult stomal catheterization was reported in 2 cases (6.8%). Conclusion: The Mitrofanoff procedure can simplify catheterization in children who are dependent upon intermittent catheterization, The appendicovesicostomy is associated with satisfactory outcomes and minimal complications and has the benefit of continent catheterizable stoma.

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