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Modified Stoma of Mitrofanoff Continent Diversion

Objective: To create a modified Mitrofanoff continent stoma with minimal incidence of stoma stenosis and incontinence. Materials and Methods: A new modified surgical technique was used to construct a catheterizable channel based on the Mitrofanoff principle at King Abdulaziz University Hospital in Jeddah. Twelve boys, 2 girls, and 1 adult were included in the study. The children’s ages varied between 6 and 13 years (mean 9 years) with different underlying etiologies, while the adult patient was 36 years old after several failed ure-throplasties. The ileal segment was isolated with its segmental blood supply, the channel constructed over 8, 10 or 12F catheters, and the selected ileal segment tapered over the catheter except for its distal part which was left tubularized, and a nipple technique was used to create the stoma. Twelve patients underwent simultaneous ileocystoplasty and 1 patient bladder neck closure. Results: Postoperative complications unrelated to stoma occurred in 5 patients including wound infection in 2 patients, metabolic acidosis with hy-perkalemia in 1 patient, vesicocutaneous fistula in 1 patient, and intestinal obstruction in 1 patient. Bladder emptying was easy to perform in 11 patients while 4 patients required recatheterization of the channel for an additional 14 days. Conclusion: Our modified surgical technique for construc-tion of a catheterizable stoma based on the Mitrofanoff principle was successful in creating a continent easy catheteriz-able non-stenotic stoma.