Mitrofanoff appendicovesicostomy

Overview
Mitrofanoff appendicovesicostomy, also known as the Mitrofanoff procedure, attaches the appendix between the skin and the urinary bladder in order to provide an outlet (a stoma) for urine. In the procedure, a surgeon removes the appendix from its place at the end of the cecum. The appendix is then washed and an opening made at its blind end. One end is connected by sutures to the bladder and the other is connected to the skin. Generally an incision is made into the umbilicus (belly button) so that it may serve as the canal for the catheter. Urine is typically drained several times a day by use of a catheter inserted into the Mitrofanoff canal. If the appendix is not available for use, a different part of the intestines may be used. For instance, in children a portion of the bowel may be used.

The procedure is typically performed when there is a blockage of the normal outlet (as in urethral cancer) or when there is a need for frequent, often uncomfortable, catheterizations (as in neurogenic bladder). The most common patients who undergo this procedure are those who are dependent on catherization to eliminate urine, such as paraplegic individuals (typically those born with spina bifida). The Mitrofanoff procedure allows the individual to self-cath so that he or she is not dependent on a family member or a medical professional to catherize him or her.