title: Pilot study of the vesicocutaneous continent catheterizable stoma (mitrofanoff) in adults--high complication rates.
abstract: OBJECTIVE
  To report our experience with an adult vesicocutaneous Mitrofanoff, an alternative to standard appendiceal or ileal Mitrofanoff.
  
  
  METHODS
  Retrospective chart review was performed on 3 patients who underwent a vesicocutaneous Mitrofanoff by a single surgeon. Data were collected on etiology, complications, and number of procedures to correct the complication.
  
  
  RESULTS
  Indications for the procedure included neurogenic bladder and urinary retention. Mean follow-up time was 485 days with mean time to first complication of 24 days. One-hundred percent of patients saw stenosis and dehiscence of their wounds. All 3 patients required subsequent surgery. Sixty-six percent required reoperation to the standard Mitrofanoff with a mean time to this procedure of 222 days. The mean number of procedures was 4 (range 2-6).
  
  
  CONCLUSIONS
  Continent catheterizable stomas have been a continuous challenge for adults who have had multiple abdominal surgeries, making a typical appendix, ureter, or small bowel Mitrofanoff difficult. We looked at our experience with a cutaneous Mitrofanoff (an extraperitoneal procedure often done in pediatrics but never before in adults) as an alternative but found complication rates of 100%. These included stenosis and dehiscence eventually requiring reoperation, with some even requiring conversion to an ileal or appendiceal Mitrofanoff. Although there are high complication rates in the standard Mitrofanoff, we conclude that a vesicocutaneous Mitrofanoff is not an effective alternative.
authors: Detroit Medical Center, Michigan State College of Osteopathic Medicine, Detroit, MI 48201, USA.
authors: Lauren
authors: L
authors: Eisenberg
authors: Jeremy
authors: J
authors: Johnson
authors: Richard
authors: R
authors: Santucci
mesh_terms: D000328:Adult; D003559:Cystostomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000601:surgery; D014546:Urinary Catheterization / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects*; D016055:Urinary Retention / Q000175:diagnosis / Q000601:surgery