Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
Division of Urology, Fundación Santa Fe de Bogotá, Colombia.
Int Braz J Urol. 2020 Sep-Oct;46(5):743-751. doi: 10.1590/S1677-5538.IBJU.2019.0388.
Continent urinary diversion (CUD) with the Mitrofanoff principle stands as an alternative to urethral catheterization by a route other than the urethra. The aim of the study was to determine self-perception of health-related quality of life (HRQoL), ease of catheterization and global and cosmetic outcomes in patient's dependent on Mitrofanoff catheterization.
Records of all patients who underwent CUD with the Mitrofanoff principle between 2012 to 2018 were reviewed. Data were collected and analysed retrospectively from medical charts. We assessed HRQoL with the EuroQol EQ-5D-3L questionnaire, cosmetic and global satisfaction with a questionnaire designed by the reconstructive urology board and ease of catheterization with a Likert questionnaire adapted from the Intermittent Catheterization Difficulty Questionnaire (ICDQ) validated in patients reliant on retrograde CIC.
A total of 25 patients requiring CUD with the Mitrofanoff principle between 2012 and 2018 were assessed, the group was composed mainly of: appendiceal conduits 18 patients (72%) and 7 ileal conduits (Yang-Monti) and three of those requiring Casale (Monti Spiral) and 1 a double Monti technique. Median follow-up was 57 months, median age was 30 years. Visual Analogue Scale (VAS) of the EQ-5D-3L reported a Global health score of 86.5%. Fifty nine percent of the patients had no pain or bleeding with catheterizations. Regarding global satisfaction and cosmetic perception 91% were satisfied with their CUD.
CUD is associated with good HRQoL, global satisfaction, ease and painless catheterization, adequate self-perception of cosmetic outcomes and a low complication rate, remaining a safe and viable option.
采用米托法诺夫（Mitrofanoff）原理的可控性尿流改道术是一种替代经尿道导尿的方法。本研究旨在确定依赖米托法诺夫导尿管的患者对健康相关生活质量（HRQoL）、导尿的便利性以及整体和美容效果的自我感知。
回顾了 2012 年至 2018 年间接受米托法诺夫原理可控性尿流改道术的所有患者的记录。从病历中收集和回顾性分析数据。我们使用 EuroQol EQ-5D-3L 问卷评估 HRQoL，使用由重建泌尿外科委员会设计的问卷评估美容和整体满意度，使用经过验证的逆向间歇性导尿（CIC）患者的间歇导尿困难问卷（ICDQ）的李克特量表评估导尿的便利性。
评估了 2012 年至 2018 年间需要采用米托法诺夫原理的可控性尿流改道术的 25 名患者，该组主要由阑尾导管 18 名患者（72%）和 7 名回肠导管（Yang-Monti）组成，其中 3 名需要 Casale（Monti Spiral）和 1 名双 Monti 技术。中位随访时间为 57 个月，中位年龄为 30 岁。EQ-5D-3L 的视觉模拟量表（VAS）报告全球健康评分 86.5%。59%的患者在导尿过程中没有疼痛或出血。91%的患者对他们的可控性尿流改道术感到满意，包括整体满意度和美容感知。
可控性尿流改道术与良好的 HRQoL、整体满意度、便利性和无痛性导尿、对美容效果的适当自我感知以及较低的并发症发生率相关，仍然是一种安全可行的选择。
