I recent met two spinal-injured women at a meeting in Ipsilanti Michigan. They described a urinary diversion procedure that I had not seen before and appears to be working very well for them. As many of you know, a mitrafanoff is a procedure where the appendix is used as a conduit between the bladder and the umbilicus (belly button), allowing people to catheterize themselves through the conduit instead of through the urethra. This not only significantly reduces urinary infections but also allows people, particularly quadriplegic women, to catheterize themselves easily and often improves the quality of life.
If the appendix is not big or long long enough, the surgeons sometimes have to use a piece of the intestine (called ileum) or colon as the conduit. Intestines, however, tend to produce mucus. This is often troublesome and can cause mucus plugs and requires flushing.
This new procedure (I don't its name but perhaps it should be called continent cutaneous vesico-vesicostomy) uses part of the bladder wall to create the conduit. This procedure is not for everybody because it requires that the bladder be of sufficient size for part of the bladder wall to be used as a conduit. The conduit goes from the bladder to the lower midline or right lower abdomen. The patients who had this procedure expressed a lot of satisfaction with the procedure and told me that it has changed their lives for the better. They also told me that they have had no problem with mucus and that surgeon made the valve opening to the stomach wall so that it would leak if the bladder pressure is too high, providing a safety valve for people with severe spasticity.
This procedure is done by Dr. McGuire at the University of Michigan in Ann Arbor. He has apparently done about 90 cases. I was unable to find a publication by Dr. McGuire from Michigan on this subject in Medline and will continue to look for it.
Wise.
If the appendix is not big or long long enough, the surgeons sometimes have to use a piece of the intestine (called ileum) or colon as the conduit. Intestines, however, tend to produce mucus. This is often troublesome and can cause mucus plugs and requires flushing.
This new procedure (I don't its name but perhaps it should be called continent cutaneous vesico-vesicostomy) uses part of the bladder wall to create the conduit. This procedure is not for everybody because it requires that the bladder be of sufficient size for part of the bladder wall to be used as a conduit. The conduit goes from the bladder to the lower midline or right lower abdomen. The patients who had this procedure expressed a lot of satisfaction with the procedure and told me that it has changed their lives for the better. They also told me that they have had no problem with mucus and that surgeon made the valve opening to the stomach wall so that it would leak if the bladder pressure is too high, providing a safety valve for people with severe spasticity.
This procedure is done by Dr. McGuire at the University of Michigan in Ann Arbor. He has apparently done about 90 cases. I was unable to find a publication by Dr. McGuire from Michigan on this subject in Medline and will continue to look for it.
Wise.
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