Hodges A M
Kagando Hospital, Kasese, Uganda.
BJU Int. 1999 Sep;84(4):436-9. doi: 10.1046/j.1464-410x.1999.00197.x.
To evaluate the results of Mitrofanoff continent urinary diversion in a group of women with persistent severe incontinence after vesicovaginal fistula (VVF) secondary to obstructed labour.
Seven women with severe incontinence following a VVF were offered the Mitrofanoff procedure after all other attempts had failed to restore continence. In three patients a caecocystoplasty formed the urinary reservoir and in four the bladder was used. In all seven patients the appendix was used as the conduit for self-catheterization. The mean (range) follow-up was 10 (3-14) months.
One patient died postoperatively from hepatic failure, which could not be attributed to the particular procedure. One patient required re-operation at 10 days to adjust the conduit, but of the six patients who recovered, all are fully continent and self-catheterizing with no difficulty.
The Mitrofanoff procedure appears to be a valuable technique to restore continence in this difficult group of patients.
