Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, 2320024, Japan.
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, 2360004, Japan.
J Med Case Rep. 2023 Oct 7;17(1):442. doi: 10.1186/s13256-023-04131-5.
The Mitrofanoff (appendicovesicostomy) procedure is a contraindicated urinary modification that maintains urinary continence by forming a flap-valve mechanism at the site of anastomosis between the appendage and bladder wall, which is used as a guide for urinary drainage. This technique has been used by intermittent self-catheterization patients who have difficulty voiding from the native urethra or in cases where voiding from the abdominal wall would improve quality of life. However, the risk of stone formation is high due to intermittent urinary catheterization using the Mitrofanoff conduit urethrostomy as a conduit.
The patient was a 22-year-old Asian-Japanese woman. At 6 years of age, she underwent bilateral vesicoureteral reflux surgery, Mitrofanoff urethrostomy using the appendix, abdominal wall plication, and vaginoplasty using the ileum. During follow-up, ultrasound performed due to persistent pain during urinary drainage revealed a 26 mm bladder stone. We performed ureteroscopic lithotripsy 6Fr using ureteral access sheath and made lithotripsy using Ho: YAG laser, then successfully removed the target stone.
We report a case of transurethral laser lithotripsy using the Mitrofanoff urethral conduit for bladder stones. Using with ureteral access sheath made lithotripsy and retrieved ureteral stone more effective.
米托法诺夫（阑尾膀胱吻合术）是一种禁忌的尿流改道术，通过在阑尾和膀胱壁吻合处形成瓣阀机制来保持尿控，该机制用作导尿引流的指南。对于因原生尿道排尿困难或从腹壁排尿会提高生活质量而进行间歇性自我导尿的患者，已经使用了这种技术。然而，由于使用米托法诺夫导尿管作为导尿管进行间歇性导尿，结石形成的风险很高。
患者为 22 岁亚裔日本女性。6 岁时，她接受了双侧输尿管反流手术、使用阑尾的米托法诺夫尿道造口术、腹壁折叠术和使用回肠的阴道成形术。在随访期间，由于引流尿液时持续疼痛而行超声检查显示膀胱结石 26mm。我们使用输尿管入路鞘进行了 6Fr 输尿管镜碎石术，并使用钬：YAG 激光进行碎石术，然后成功地取出了目标结石。
我们报告了一例使用米托法诺夫尿道导管进行经尿道激光碎石术治疗膀胱结石的病例。使用输尿管入路鞘进行碎石术和取石术更有效。
