Living with a urinary catheter

Using a Mitrofanoff for intermittent self catheterisation

People who are incontinent or who cannot empty their bladder through their urethra, and who have poor use of their hands (manual dexterity), may have an indwelling catheter or rely on professional carers for bladder management. Sometimes, however, it may be possible for them to practice intermittent self catheterisation via a Mitrofanoff. This procedure can help people to remain independent.

The Mitrofanoff procedure creates a channel that acts in the same way as a urethra. It is made from the appendix, bowel, or both.  It’s a complex operation.  The surgeon separates the appendix from its attachment to the bowel, while maintaining its blood supply, then creates an opening at its blind end and washes it. One end is connected by surgical sutures to the bladder, and the other is connected to the skin to form a stoma. The channel runs from the bladder to an exit either through the umbilicus (belly button) or beside it. Intermittent self catheterisation through the Mitrofonoff is needed to empty the bladder.

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Rachael was born without a bladder, and with a malfunctioning kidney. Doctors created a bladder from part of her bowel. When she was six years old she was taught to empty her bladder via her urethra. Despite intermittent self catheterisation she was often incontinent. When Rachael was aged 10 doctors decided to create a Mitrofanoff, using her appendix and her bowel.

Rachael says that having a Mitrofanoff has changed her life for the better. She says that having a Mitrofanoff is better than practicing intermittent self catheterisation via her urethra.

Rachael has found support from family, friends and via a group of other people who have a Mitrofanoff on Facebook.  She has also found help from Mitrofanoff Support website.
Rachel has had excellent care from health professionals over the years but thinks it is important that doctors and nurses admit to uncertainty because they do not always know what to do when she asks for help.

We interviewed another woman, Hayley, who had a suprapubic catheter but who wanted a Mitrofanoff. She thought that intermittent self catheterisation via a Mitrofanoff would reduce the number of urine infections that she had each year. Hayley has not yet managed to persuade her doctor that she should have a Mitrofanoff.

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Last reviewed June 2015.
Last updated June 2015.

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