What is the Mitrofanoff Procedure? Let's talk about it simply.

Sometimes we have to face health problems that we can't even imagine. Not being able to urinate normally is one of them. Today we are talking about a special surgery that is performed as a solution when the bladder cannot be controlled properly due to certain medical conditions. Don't be afraid to hear this. It is very important to be aware of this.

What is Mitrofanoff surgery?

Simply put, this is a surgical procedure. It involves creating a small tube-like channel from your bladder to the surface of your stomach. Think of it like creating a new entrance to your bladder. Surgeons use a part of your own body called the appendix to create this channel.

Then, a special tube, called a catheter, is inserted into this small opening in the abdomen (called a stoma ) to empty the bladder. This is easier and less painful for many people than having a catheter inserted through the urethra.

To understand this, let's first look at how our urinary system works.

The urinary system in our body is like a filter system.

• First, our kidneys filter the blood, separate waste products, and produce urine.
• This urine then travels down two small tubes called ureters and collects in the bladder .
• The bladder is an organ made of muscles that stretch like a balloon. It is only when it is full that we feel the need to urinate.
• When we urinate, urine passes from the bladder to the outside of the body through a tube called the urethra .

Due to some medical conditions, this process does not occur properly. That's when a method like Mitrofanoff is needed.

So what is the appendix?

The appendix is ​​a small, finger-like tube that is attached to the first part of our large intestine. It is located on the lower right side of our stomach.

Doctors still haven't figured out what other function it plays. Some say it protects the good bacteria in our intestines. But the most important thing is that we can live a healthy life without any problems without an appendix. You may have heard that when you have appendicitis, you have to have it removed. That's how it is.

In the Mitrofanoff procedure, doctors take the appendix and use it to create a new passageway for urine to pass out. If a person's appendix has already been removed, the surgeon can use a section of the small intestine to create this passageway instead.

Who needs this surgery?

This surgery may be necessary for both children and adults. Let's break down the main conditions that cause it.

How the surgery is performed and recovery time

Before surgery

Before surgery, you need to completely empty your bowels to reduce the risk of infection. This will require you to follow your doctor's instructions exactly. This means fasting and performing a bowel cleanse.

During surgery

This surgery is performed under general anesthesia. This means you won't feel anything, you'll be asleep. The surgeon will follow these steps:

1. The stomach skin is cut (incision) and the appendix is ​​separated from the large intestine.

2. One end of the ileostomy tube is connected to the bladder and the other end to a small opening (stoma) made in the abdomen.

3. The connection to the bladder is made like a valve that automatically closes when the bladder is full. This stops urine from leaking.

4. After surgery, a temporary tube (suprapubic tube) is inserted to allow urine to pass through until the bladder heals.

5. Finally, the surgical site is closed with dissolvable stitches.

After surgery

You will need to stay in the hospital for a few days, possibly a week. During your recovery, you can expect the following:

• Only saline (IV fluids) will be given for a few days.
• For the first 4-6 weeks, a catheter is placed inside the newly created passageway (Mitrofanoff tunnel) to prevent it from closing.
• After about 6 weeks, your doctor will teach you how to empty your bladder on your own using a catheter.

What are the benefits and risks of this?

However, like any surgery, there are some risks.

• Reoperation required: Over time, the created passageway can become narrowed (stenosis) or weakened, requiring another surgery to repair it.
• Mucus production: Even when the appendix is ​​re-used, it continues to produce mucus. Therefore, this passage must be kept clean by regular irrigation with a solution such as saline.
• Other risks: Bladder stones, urinary tract infections (UTIs), and bleeding may occur.

Don't be afraid of these risks. Your doctor will inform you about all of this and give you the necessary advice.

When do you need to talk to the doctor?

If you experience any of the following symptoms after surgery, inform your doctor immediately or go to the Emergency Department (ETU) of the nearest hospital .

• If you cannot empty your bladder completely.
• If there is excessive bleeding, swelling, or bruising.
• If nausea and vomiting persist.
• If there is severe, unbearable pain.
• Signs of infection, such as foul-smelling discharge from the stoma or fever.

Mitrofanoff procedure, bladder, catheter, stoma, neurogenic bladder, self-catheterization, appendicitis, appendix, urinary problems