Mitrofanoff Procedure

What is a Mitrofanoff?

Surgeons use the Mitrofanoff procedure to make a channel from the outside of your child's abdomen into their bladder using the appendix. The channel looks like an extra belly button. A thin, plastic tube called a catheter can be put through the channel into the bladder to drain urine instead of urinating through the urethra. The urethra is the tube that normally allows urine to leave the body.

The surgeon may also operate on your child's bladder at the same time to enlarge it.

Why does my child need a Mitrofanoff?

Children who have trouble draining their bladder may benefit from this surgery. The Mitrofanoff procedure is often used for children with bladder problems due to spina bifida, bladder exstrophy or bladder blockage.

The Mitrofanoff is used to empty your child's bladder several times a day, which reduces the chance of urine leaking from the bladder. A catheter is placed into the Mitrofanoff rather than the urethra. Placing a catheter into the Mitrofanoff instead of the urethra can be easier and more comfortable for your child.

How do I help prepare my child for a Mitrofanoff procedure?

We'll provide information about how to prepare your child for the surgery by phone and through the mail before the surgery date.

Your child should not have anything to eat or drink before the surgery. A care team member will tell you when your child must stop eating and drinking before surgery. It is important to follow the eating and drinking rules before surgery. If you do not follow these instructions, your child's surgery may need to be delayed or even cancelled.

Tell the doctors about any medical problems your child has, such as allergies and constipation. Please also bring in any medicines your child is currently taking.

What happens during the Mitrofanoff procedure?

This surgery will be done under general anesthesia. General anesthesia helps your child fall into a deep, sleep-like state that keeps them from feeling pain during surgery. The surgeon will disconnect your child's appendix from its normal place on the large intestine and open it up to form a channel.

The surgeon will then connect one end to a small incision (cut) in your child's bladder and the other end to another small incision in your child's abdomen. The surgeon will also make a valve where the tube joins the bladder, which squeezes shut as the bladder fills with urine. This will lower the chance of urine leaking from the Mitrofanoff. If your child has had their appendix taken out in the past, the surgeon may need to use a piece of the small intestine to make the channel.

The surgery will take about three hours, but it can take longer if your child is going to have another procedure at the same time. Your child will stay in the hospital for five to seven days.

What can we expect after my child's Mitrofanoff procedure?

For the first day or two after surgery, your child will have intravenous (IV) fluids and medicines until the bowel starts to heal. A provider will take the IV out when your child starts eating and drinking again. The surgeon will put a catheter into the Mitrofanoff to keep it open. The catheter should stay in place for three to four weeks after the surgery.

Your child may also have a suprapubic catheter for a while after the operation to allow the bladder and Mitrofanoff to heal. The surgeon places this catheter into the bladder through an incision in the abdomen. The incision is a few inches below the belly button. The catheter will be connected to a collection bag so urine can drain freely from the bladder.

It is common for children to have bladder spasms after this operation. You will know if your child is having pain from bladder spasms because it will come on quickly. This is normal. A small amount of urine with some blood in it may also leak from your child's urethra.

How do I care for my child at home after a Mitrofanoff procedure?

• Bladder spasms: We will provide medicine to your child for bladder spasms before you go home.
• Pain: Acetaminophen (Tylenol) or ibuprofen will be enough to take care of any pain your child may have for a few days after the surgery. Follow the doctor's instructions on how and when to give your child pain medicine.
• Follow-up appointment: Your child will have a follow-up appointment in three to four weeks so you can learn how to place the catheter into the Mitrofanoff to empty their bladder.

Why choose Children's Hospital Colorado for my child's Mitrofanoff procedure?

At Children's Colorado, we have a multidisciplinary care team that is dedicated to ensuring that your child is prepared for surgery. We provide the highest standard of surgical care. We also constantly measure and improve our surgical outcomes. This is one reason why we have the largest reconstructive (Mitrofanoff) practices in the Rocky Mountain Region.

If you have any questions or concerns after the procedure, call the ParentSmart Healthline at 1-855-KID-INFO (543-4636). Caring pediatric nurses are available 24 hours a day, 7 days a week to help answer your questions.