Adaptations of the Mitrofanoff principle in adult continent urinary reservoirs.

Among the different techniques to develop a continence mechanism in continent urinary diversion, the Mitrofanoff principle of creating a submucosal tunnel for implantation of a catheterizable tube has gained in popularity. Early experience in the pediatric population focused on use of the appendix and ureter as the efferent limb, while bladder served as the reservoir. Recent developments have demonstrated that any segment of bowel can be tapered and implanted to achieve continence. Colonic teniae serve as an ideal site for implantation of the tube. The continence achieved with implantation of a supple straight tube beneath a tenia of colon is excellent. Success with this form of continence has made it our preference when converting an ileal or colon conduit to a continent reservoir.