Outcomes of urinary diversion in children with spinal cord injuries.
OBJECTIVE
To gain a better understanding of the outcomes of the Mitrofanoff procedure for urinary diversion in children with spinal cord injury (SCI).


METHODS
Descriptive retrospective.


METHODS
Individuals 6 to 27 years of age with SCI with at least 1 year follow-up after the Mitrofanoff procedure. Objective data collected via retrospective chart review include general demographics and medical/surgical history. Data collected via structured telephone interview include history of adverse urological events, bladder management, bladder management independence scores, patient satisfaction, and quality of life.


RESULTS
Sixteen subjects (13 female, 3 male) with a mean age of 19 years (range 6-27 y) who underwent the Mitrofanoff procedure were interviewed. Length of postoperative follow-up ranged from 1 to 8 years (mean 4.25 y). Complications included stomal stenosis 25% (n=4) with a mean of 19 months to first occurrence of stenosis; urethral incontinence 75% (n=12); renal/bladder calculi 19% (n = 3); and stomal leakage 44% (n=7). Independence scores for bladder management after the Mitrofanoff procedure improved in 84% of subjects with tetraplegia and 25% of subjects with paraplegia. Eighty-eight percent (n 14) were satisfied with the procedure, while 12% (n=2) were somewhat satisfied. A thematic analysis of quality of life revealed that freedom (35%) and independence (35%) were most commonly cited.


CONCLUSIONS
While some subjects experienced complications, satisfaction was relatively high and level of independence in bladder management was greatly improved. This study demonstrates that the Mitrofanoff procedure is a beneficial option to improve independence and ease of bladder management in children with SCI.
Merenda
Lisa A
LA
Shriners Hospitals for Children, 3551 N. Broad St., Philadelphia, PA 19140, USA. lmerenda@shrinenet.org
Duffy
Theresa
T
Betz
Randal R
RR
Mulcahey
Mary Jane
MJ
Dean
Gregory
G
Pontari
Michel
M
D000293:Adolescent; D000328:Adult; D002648:Child; D003559:Cystostomy / Q000009:adverse effects / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000009:adverse effects / Q000523:psychology; D014555:Urination Disorders / Q000209:etiology* / Q000523:psychology / Q000601:surgery*