The Mitrofanoff urinary diversion for complex vesicovaginal fistulae: experience from Uganda.
OBJECTIVE
To evaluate the results of Mitrofanoff continent urinary diversion in a group of women with persistent severe incontinence after vesicovaginal fistula (VVF) secondary to obstructed labour.


METHODS
Seven women with severe incontinence following a VVF were offered the Mitrofanoff procedure after all other attempts had failed to restore continence. In three patients a caecocystoplasty formed the urinary reservoir and in four the bladder was used. In all seven patients the appendix was used as the conduit for self-catheterization. The mean (range) follow-up was 10 (3-14) months.


RESULTS
One patient died postoperatively from hepatic failure, which could not be attributed to the particular procedure. One patient required re-operation at 10 days to adjust the conduit, but of the six patients who recovered, all are fully continent and self-catheterizing with no difficulty.


CONCLUSIONS
The Mitrofanoff procedure appears to be a valuable technique to restore continence in this difficult group of patients.
Hodges
A M
AM
Kagando Hospital, Kasese, Uganda. hodges@eurobell.co.uk
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012086:Reoperation; D016896:Treatment Outcome; D014454:Uganda; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000601:surgery*