Continent urinary diversion : mitrofanoff principle experience at King Hussein Medical Center

Abstract EN

Objective : Continent urinary diversion has become increasingly popular in many specialized centers all over the world for treating total urinary incontinence that could not be managed by direct reconstructive techniques.

However, we started to perform this new reconstructive procedure at King Hussein Medical Center for the first time in Jordan in 1994.

Our experience in this relatively new technique using the Mitrofanoff principle to achieve continence in 12 urinary incontinent children during the past 5years was reviewed in this article.

Methods : The total number of urinary incontinent patients who were subjected to continent urinary diversion using the Mitrofanoff principle since February 1994 through April 1999 was 12 patients.

Their ages ranged between four and 13 years with a mean of 8.5 years.

The pathological conditions included failed repair of bladder extrophy-epispadias complex in six patients, neurogenic bladder due to meningomyelocele in two, post cloacal repair in one, neglected bladder extrophy in one and sacral agenesis in two patients.

Results: Continent urinary diversion using the Mitrofanoff principle provided urinary continence in 10 out of 12 patients with a success rate of 83 %.

Conclusion: Total urinary incontinence represents a real challenge to the pediatric surgeon to plan how to help an unlucky child with this medical and social problem.

Many options exist for reconstructing complex anomalies but choices must be individualized based on the patient anatomy and clinical problem.

The dry state may be achieved in most cases without restoring a bag to the abdominal wall The Mitrofanoff principle is an efficient method to create an easily catheterisable stoma on the abdominal wall.