Intermittent Catherization with a supra public stoma
Maeker, Valerie D.
Hi Wes & Jocelyn (& the rest of the SCI support group members),
I couldn’t think of the procedure that allowed for intermittent catheterization through a suprapublic stoma while at the SCI support group so I did a little research. It is called a mitrofanoff. I have had several clients, not children get them, and they work great. I thought they were one in the same but I see they are slightly different. Here is some info that I pulled from the net that I thought my be informative for you…
Here is info I found:
MITROFANOFF
Many children having bladder augmentation will also have a Mitrofanoff procedure. This is a surgery that
uses the appendix or a piece of intestine to create a catheterizable channel from the stomach to the bladder.
A catheter (tube) can then be used to drain urine from the bladder through this opening (stoma) in the
stomach. This surgery is done if you or your child have trouble catheterizing the bladder through the urethra
(tube that drains the bladder). The stoma is continent (urine does not leak from the stoma) as long as you or
your child catheterizes his/her bladder at least once every 4 hours.
After this procedure is done, there will be a catheter in the stoma for 3 weeks after surgery. This is to
prevent the opening from closing.
Mitrofanoff vs. super pubic cathater
07-01-2012, 08:57 PM
Hello. My names katlin. I'm a C5-6 ASIA C incomplete. Im 2 years out from my injury and I'm 19 years old. I'm wondering about the mitrofanoff and super pubic cathater and what everyone thinks of the two. I would like to be more independent and this would help a ton. I've heard goods and bass for both. Any suggestions?
gjnl
07-01-2012, 10:10 PM
How are you currently managing your bladder?
All the best,
GJ
07-01-2012, 10:21 PM
Just straight cathing every 4 hours. But I'm not able to do it. So it's a pain
smashms
07-01-2012, 10:43 PM
i was offered 3 choices the mitro, sp tube or an ileal conduit and for me i chose the conduit as i could no longer cath either i am able to manage the conduit myself, i am a low para but have dexterity issues because of another disease i have. good luck to you on your choice i will give you an excellent website that has a ton of info on it is uoaa.org great info on there and even a message board.
gjnl
07-01-2012, 11:03 PM
Just straight cathing every 4 hours. But I'm not able to do it. So it's a pain
I totally understand not being able to manage your own catheterization and even if your were the impact that a 4-6 hour schedule of catheterization imposes on your lifestyle.
That said, my advise is on the conservative side, and I advocate baby steps before taking steps toward major urologic surgeries. In that you are having issues with intermittent catheterization, my suggestion would be to try indwelling urethral foley for a while
and then go to a suprapubic catheter or just go from where you are now to a suprapubic catheter and see how that goes for a while. You can always have the major surgeries, but you may have many good years on a suprapubic and not have to endure highly invasive
surgeries with long recovery times.
All the best,
GJ
SCI-Nurse
07-01-2012, 11:10 PM
I would recommend the Mitrofanoff first. If you have an indwelling catheter inserted, your bladder is going to shrink, and if you then
later decided you wanted to go back to intermittent cath with a Mitrofanoff, you might also have to have the much bigger surgery of an augmentation to get your capacity back. You can always go to an indwelling catheter later if you don't like the Mitrofanoff.
(KLD)
rybread
07-02-2012, 04:21 AM
I have a suprapubic catheter. I've had it for the past 10 1/2 years. It's taken care of bladder spasms I used to get and is really easy for my family or friends to take care of. The one problem is that I've had it for so long my bladder has shrunk so my catheter plugged up which it does once a week at this point, I get dysreflexic with anything over 200 mL of urine in my bladder. If you can manage inserting a catheter into a hole around your belly button, I would definitely go with that surgery, but I guess it depends on how much function you have in your hands. Good luck on whatever you decide
crypticgimp
07-02-2012, 06:33 AM
being young and active, i wouldnt recommend a procedure that has you hooked up to a catheter, and as kld said, you can always go to a sp or a foley(tho foleys can cause damage to your urethra over time). i love my mitro, it requires very little maintenance and it's made my life so much better!
07-02-2012, 10:07 AM
Thanks everyone. Is the mitrofanoff reversable? Is there any big risks wih getting that done?
gjnl
07-02-2012, 11:43 AM
While you are making your decision, I think there are some questions you need to ask yourself.
1. Where is the opening for the mitrofanoff?
2. What kind of clothing alterations and changes will you need to make to access the stoma?
3. As a C5/6 quad, can you manage intermittent catheterization every 4-6 hours by yourself or will you need assistance?
You might want to talk to a stoma nurse to understand the stoma placement and access issues.
All the best,
GJ
Lorrie
07-02-2012, 12:19 PM
Go for mitrofanoff. It's a rough surgery but worth it. Hopefully you won't need the augmentation to make your bladder larger. Insist on belly button placement!
crypticgimp
07-02-2012, 01:09 PM
there are NO clothing alterations needed to access the stoma for the mitro. just lift up your shirt, insert catheter and go :P if you wear a binder then you'll need an access hole but other than that, nothing required.
Liz321
07-02-2012, 01:23 PM
there are NO clothing alterations needed to access the stoma for the mitro. just lift up your shirt, insert catheter and go :P if you
wear a binder then you'll need an access hole but other than that, nothing required.
and ensure you pick the spot that you can reach it. Mine is in my belly button.
Retrieved from: http://sci.rutgers.edu/forum/archive/index.php/t-191817.html
There is also a continent stoma that can be created.
What is a continent stoma?
In some cases, a continent stoma is created during the bladder augmentation so that you can drain your augmented bladder more easily. A continent stoma is a small tube made out of appendix, bladder, or intestine that connects a small opening on your abdomen to the bladder. You can insert a catheter into this opening, access your bladder, and drain the urine. The continent stoma has a biologic valve in it to prevent urine from leaking. You may meet with an enterostomal therapy nurse prior to surgery to find to optimal location for the stoma on your abdomen.
Retrieved from: http://www.med.umich.edu/1libr/urology/BladderAugmentation.pdf
I hope this information is helpful to you and the rest of the SCI support group. I know 3-4 people who have had the mitrofanoff and would be willing to talk to you about it if your are interested.
Thanks,
Valerie