[Mitrofanoff appendicovesicostomy in children: indication and results].
OBJECTIVE
To present the indications and short-term and long-term results of Mitrofanoff appendicovesicostomy in children.


METHODS
Between 1992 and 2004, 13 boys and 17 girls underwent Mitrofanoff appendicovesicostomy with creation of a stoma in the right iliac fossa. The mean age was 10 years (range: 5-15 years). The indication for surgery was neurogenic bladder (28 cases) and altered bladder secondary to posterior urethral valve (2 cases). The diagnosis was established at an advanced stage with moderate renal failure in 16 cases (mean creatinine clearance: 60 ml/min/1.73 m2).


RESULTS
Mean follow-up was 53 months (range: 24 to 156 months). All children were continent and 29 (96.66%) of them were continent after only one operation. Complications were minor essentially consisting of difficulties of intermittent catheterization (13.3%). Renal function deteriorated to end-stage renal failure in one case 6 years after the operation, remained stable in 9 cases (mean creatinine clearance: 72 ml/min/1.73 m2) and returned to normal in 6 cases. Intermittent self-catheterization was accepted by all children with complete readaptation to daily activities.


CONCLUSIONS
Mitrofanoff appendicovesicostomy gives good results in children. It ensures good continence, a low complication rate and satisfactory school and social readaptation. The results of this study are comparable to those of the literature in terms of success and durability of this type of diversion in children.
Mhiri
Mohamed Nabil
MN
Service d'Urologie, CHU Habib Bourguiba, Sfax, Tunisie.
Bahloul
Ali
A
Chabchoub
Kamel
K
D000293:Adolescent; D001065:Appendix / Q000601:surgery*; D002404:Catheterization / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000032:analysis; D003559:Cystostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012917:Social Adjustment; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent
D003404:Creatinine