The document provides information about the Mitrofanoff procedure, which creates a channel from the bladder to the abdominal wall to allow catheterization, explaining how it works and the recovery process after surgery, including being taught self-catheterization; it also discusses potential complications and recommendations for follow-up care.

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Mitrofanoff procedure
This operation was designed to help people who are
incontinent of urine or cannot empty their bladder completely
via their urethra. Your surgeon will explain the details of the
procedure, how it works and what will happen after the
operation, both in the short and long term.
To create a mitrofanoff stoma, the (See separate information sheet
surgeon will take your appendix on Bladder Augmentation).
and connect one end to your
bladder and the other end to the You may be admitted to hospital
wall of your abdomen (tummy), a few days before surgery. This is
either into the navel or lower down to make sure you are well enough
below the level of most underwear. to have the operation. Also,
This small opening (stoma) is used sometimes it is necessary to
to pass a tube called a catheter, empty the bowel and make sure
along the new channel into the it is clean before the procedure
bladder so it can be emptied. If you is started. A clean, empty bowel
have already had your appendix is especially important if you are
removed, don’t worry. There are having your bladder enlarged.
other ways of making a Mitrofanoff This helps to prevent infections
channel. One way is by using a after the surgery. The bowel is
tiny segment of small bowel. usually cleaned by temporarily
changing your diet to clear fluid
Some people also have their drinks only (for one or two days)
bladder enlarged at the same time and by taking medicine that
as having the Mitrofanoff. empties the bowel.

2. Mitrofanoff procedure
Although you will not be able to opinion. Urinary tract infections
eat and drink immediately after sometimes occur following this
surgery, you should be up and type of operation (especially if you
around and eating and drinking are not careful about keeping to a
as usual after about 2 - 3 days. clean catheterisation routine), but
Your stay in hospital will usually cranberry juice is known to reduce
be about 3-5 days. After the the risk of these occurring.
operation and when you go home,
a catheter will stay in the stoma for Catheterisation via mitrofanoff is
up to six weeks, to drain urine from not a sterile procedure, but is a
the bladder. You will then be asked clean one. This is how it should be
to come back to the hospital and performed. Make sure you have
will be taught how to catheterise everything you need before you
the bladder through your stoma. start.
Many people will already know the
basic principle because they have • A clean or new catheter each
been using a catheter to empty time you catheterise
urine through the urethra (the tube • Somewhere to wash/clean your
through which urine leaves the hands
body) for some time. • A toilet or container to collect
the urine
The nurse or doctor will help
you do your first catheterisation. Wash your hands and prepare
Sometimes a washout is done your catheter. Gently introduce
at the same time. This just clears the catheter into your stoma,
your bladder of any ‘debris’ making sure you go far enough in
which can cause problems to drain the urine. When the urine
by blocking the catheter. You has stopped draining, advance
can reduce the amount of this the catheter about a centimeter
‘debris’ by drinking a glass of further to ensure your bladder is
cranberry juice every day. If you completely empty. Then slowly
are on blood thinning medicines remove the catheter, twisting it
you should not take cranberry. as you do so and throw it away.
If you are unsure seek medical Some catheters can be rinsed

3. and stored in a clean container, You should also let your doctor or
depending on the type of catheter nurse know if you have any of the
that you have chosen to use. following:
Wash your hands again.
• Blood in the urine.
As with any surgery, sometimes • Smelly urine.
problems do occur. The stoma can • A temperature causing you to
occasionally become narrowed shiver or sweat.
(stenosed). If it becomes difficult • Difficulty draining any urine.
for you to catheterise your stoma, • Urine leaking from your urethra
this could be the reason. If this or stoma, which hasn’t happened
happens it is important for you to before.
contact your doctor or specialist
nurse immediately. At this stage, if Never leave catheterisation for
a problem is developing, it is fairly longer than four hours during the
easy to correct. This usually means day. Your bladder may overfill and
either leaving a catheter in for a there is a real risk that it could
few days or stretching the stoma, burst if you have also had surgery
under a short general anaesthetic, to your bladder neck.
(not as bad as you think!). Do not
wait until you cannot pass the It is recommended that you wear a
catheter at all, as this can often “Medic-Alert” (Tel: 020 7833 3034)
be too late and will need more to alert medical professionals that
major surgery to fix. Apart from you have had a Mitrofanoff. If you
problems with stenosis of the have any problems or questions
stoma, difficulties in completely concerning your Mitrofanoff, you
emptying the bladder, and urine should ask your doctor, continence
infections can occur. nurse or Shine Specialist Adviser.

4. Further information and
resources
Radar - The disability network
offers a key scheme which allows
people with disabilities access
to locked public toilets. Visit
www.radar.org.uk or telephone
0207 250 3222 to find out more.
Help us
Shine relies on people’s generosity and support so we can help our clients
who depend on us for help and advice - people with hydrocephalus,
spina bifida, their families and carers. To donate to Shine please visit
www.shinecharity.org.uk or call 01733 421329.
This information has been produced by Shine’s medical advisers and
approved by Shine’s Medical Advisory Committee of senior medical
professionals.
Shine - Registered charity no.249338
To see our full range of information sheets and to find out how to donate
to Shine please visit www.shinecharity.org.uk