Sumfest J M, Burns M W, Mitchell M E
Department of Pediatric Urology, Children's Hospital and Medical Center, Seattle, Washington.
J Urol. 1993 Dec;150(6):1875-7; discussion 1877-8. doi: 10.1016/s0022-5347(17)35921-9.
We report the use of the Mitrofanoff principle to achieve urinary continence in 47 patients. A catheterizable channel can be used as the primary continence mechanism, or as an adjunct to ensure complete bladder emptying if urethral catheterization or voiding is inadequate. Appendico-vesicostomy was performed in 25 of 47 patients (55%). Satisfactory continence was achieved in 45 patients (96%). Bladder emptying by clean intermittent catheterization was performed in all patients. Early complications included peristomal abscess (1 patient) and small bowel obstruction (1). Late complications included difficulty with catheterization (5 patients), stomal stenosis (9) and persistent incontinence (2). Our results support use of the appendix as the catheterizable segment of choice. We describe the technique and discuss the management of complications.
我们报告了应用米氏原理使47例患者实现尿失禁控制的情况。可导尿通道可作为主要的控尿机制，或者在尿道插管或排尿不充分时作为辅助手段以确保膀胱完全排空。47例患者中有25例（55%）实施了阑尾膀胱造口术。45例患者（96%）实现了满意的尿失禁控制。所有患者均通过清洁间歇性导尿进行膀胱排空。早期并发症包括造口周围脓肿（1例患者）和小肠梗阻（1例）。晚期并发症包括导尿困难（5例患者）、造口狭窄（9例）和持续性尿失禁（2例）。我们的结果支持将阑尾作为首选的可导尿节段。我们描述了该技术并讨论了并发症的处理。
