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.
A consultant explains what a Mitrofanoff is.
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.
Rachel has had a Mitrofanoff for nearly 23 years. She explains what it is.
Lifting her sweater Rachel displays her stoma.
Rachel explains exactly how she drains urine from her bladder through her Mitrofanoff.
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.
Since Rachel had the Mitrofanoff operation she has been continent which she says is amazing.
Rachel explains why she thinks that self catheterisation via a Mitrofanoff is better than 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.
Rachel thinks that it is important that health professionals listen to the patient. She says that some health care workers are more willing to learn than others.
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.