Mitrofanoff principle for continent urinary diversion.

In 1980 Mitrofanoff described a method to achieve continent urinary diversion by surgically closing the bladder neck and creating a continent catheterizable stoma from the appendix which had been implanted in a nonrefluxing manner into the bladder or from a nonrefluxing distal ureter. The Mitrofanoff principle (MP) serves well as a continence mechanism for either the native bladder or intestinal reservoirs. We review 17 patients, including 10 children, who were treated with the MP and received a continent catheterizable channel. For the MP, appendix was used in 16 patients and ureter in 1. The continuity between the urinary reservoir and urethra was maintained wherever possible. Bladder neck suspension was preferred to bladder neck closure in incontinent females and boys. Complications and their management have been discussed at length. Stable renal functions, ease of catheterization and urinary continence were achieved in 93.8% of the patients.