Published 2015-04-01
Yopie T Satyawan Arry Rodjani Irfan Wahyudi


Objective: We evaluate the initial experience of the implementation of the urinary diversion procedure in patients with neurogenic bladder continence in children. Material & method: The study was conducted retrospectively by collecting data contained in patient medical records of patients who come for treatment to Cipto Mangunkusumo Hospital Jakarta, from 2003 to 2012, and by interviews with parents of patients over the phone or when the patients control to the clinic. The patient is a child (age 0-18 years), diagnosed with congenital neurogenic bladder, and had urinary diversion continence procedure. Results: There are eight cases with urinary diversion continence undertaken in Cipto Mangunkusumo Hospital and found only 7 cases met the inclusion criteria with more girls than boys. Common etiology was spina bifida (57%). Most of the patients complained of recurrent UTI, and the most techniques used are Mitrofanoff (72%) with complications 33%. Conclusion: Urinary diversion continence procedure that has been done in Urology of Cipto Mangunkusumo Hospital is Mitrofanoff-Monti. Of the total of seven cases performed, the initial evaluation gives good results after urinary diversion continence procedure. Improved quality of life of patients with the achievement continence, overcome recurrent UTI problems and kidney function can be retained. Keywords: Neurogenic bladder, Mitrofanoff techniques, Yang-Monti.



Galli G, Aubert D, Besancon, France. Epidemiology of neurogenic bladder dysfunction in children. In: Esposito C, Guys JM, Gough D, Savanelli (editors). Pediatric Neurogenic Bladder Dysfunction: Diagnosis, Treatment, Long Term Follow Up. Germany: Springer; 2006. p. 23-33.

Cassini MF, Rodrigues AA, Tucci Jr S, Cologna AJ, Reis RB, Martins ACP, et al. Using Mitrofanoff’s principle and Monti’s technique as a surgical option for bladder augmentation with a continent stome: a case report. J. Medicalcasereports. 2011; 5: 49.

De Jong TPVM, Chrzan R, Klijn AJ, Dik P. Treatment of the neurogenic bladder in Spina Bifida. Pediatr Nephrol. 2008 June; 23(6): 889-96.

Kaefer M, Retik AB. The Mitrofanoff principle in continent urinary reconstruction. Urol Clin North Am. 1997; 24(4): 795-811.

Heij HA, Ekkelkamp S, Moorman-Voestermans CGM, Vos A. Application of mitrofanoff principle in children with severe impairment of bladder function. Pediatr Surg Int. 1997; 12: 286-8.

Farrugia MK, Malone PS. Educational Article: The Mitrofanoff Procedure. J Purol. 2010; 6: 330-7.

Mitchell ME. Editorial: Alternatives to appendix in construction of a mitrofanoff stoma. J Urol. 1998; 159: 529.

Adams MC, Joseph DB. Urinary tract reconstruction in children. In: Kavoussi LR, Novick AC, Partin AW, Peters CA, Wein AJ, editors. Campbell-Walsh Urology, 9th ed. Philadelphia: Saunders Elsevier; 2007. p. 3694-6.

Geng V, Eelen P, Fillingham S, Holroyd S, Kiesbye B, Pearce I, et al. Indications for continent urinary diversion. In: Good Practice in Health Care; Continent Urinary Diversion. European Association of Urology Nurses; 2010. p. 14-5.

Hasan ST, Marshall C, Neal DE. Continent urinary diversion using the Mitrofanoff principle. BJUI. 1994; 74: 454-9.

Duckett JW, Snyder HM. Continent urinary diversion: Variations on the Mitrofanoff principle. J Urol. 1986; 136: 58-62.

Mitrofano FFP. Trans-appendicular continent cystostomy in the management of the neurogenic bladder. Chir Pediatr. 1980; 21: 297-305.

Monti PR, de Carvalho JR, Arap S. The Monti procedure: applications and complications. Urology. 2000; 55: 616-21.

Sumfest JM, Burns MW, Mitchell ME. The Mitrofanoff principle in urinary reconstruction. J Urol. 1993; 150: 1875-8.

Hosseini J, Kaviani A, Mazloomfard MM, Golshan AR. Monti’s procedure as an alternative technique in complex urethral distraction defect. International Braz J Urol. 2010; 36(3): 317-26.

Leslie JA, Dussinger AM, Meldrum KK. Creation of continence mechanisms (mitrofanoff) without appendix: the Monti and spiral Monti procedures. Urology Oncoloy: Seminars and Original Investigation; USA. 2007; 25: 148-53.

Dahl DM, McDougal WS. Use of intestinal segments in urinary diversion. In: Kavoussi LR, Novick AC, Partin AW, Peters CA, Wein AJ, editors. Campbell-Walsh Urology, 9th ed. Philadelphia: Saunders Elsevier; 2007. p. 2534-78.

Harris CF, Cooper CS, Hutcheson JC, Snyder HM. Appendicovesicostomy: The Mitrofanoff procedure-a 15 year perspective. 3rd Ed. J Urol. 2000; 163: 1922-6.

Cain MP, Casale AJ, King SJ, Rink RC. Appendicovesicostomy and new alternatives for the Mitrofanoff procedure: Results in the last 100 patients at Riley Children’s Hospital. J Urol. 1999; 162: 1749-52.

Van Savage JG, Khoury AE, McLorie GA. Outcome analysis of Mitrofanoff principle applications using appendix and ureter to umbilical and lower quadrant stoma sites. J Urol. 1996; 156: 1794-7.

Yang WH. Yang needle tunneling technique in creating anti-reflux and continent mechanisms. J Urol. 1993; 150: 830-4.

Monti PR, Lara RC, Dutra MA, de Carvalho JR. New techniques for construction of efferent conduits based on the Mitrofanoff principle. Urology. 1997; 49: 112-5.

Potter SR, Charambura TC, Adams JB. Laparoscopic ileal conduit: five-year follow-up. Urology. 2000; 56: 22.

Woodhouse CRJ. The Mitrofanoff principle for continent urinary diversion. World J Urol. 1996; 14: 99-104.

Kozminski M, Partamian KO. Case report of laparoscopic ileal loop conduit. J Endourol. 1992; 6: 147.

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Department of Urology, Faculty of Medicine/Airlangga University