For women, intermittent cathing while sitting in a chair or transferring to cath every four hours is difficult and time-consuming. But what’s a girl to do? Enter the “Mitrofanoff” procedure, which was developed in 1980 by Dr. Paul Mitrofanoff.
The women in my SCI circle have had a lot of discussion on the benefits of this procedure, and the term I have been hearing frequently is “game changer.” But what exactly is the Mitrofanoff procedure? Here is the definition from the Urostomy Association:
An urinary reservoir that is fashioned from bowel or the person’s own bladder and may be used as the reservoir. A channel is created from the appendix, ureter, or ileum. The diversion is continent because of the valve arrangement, which prevents urinary leakage. The channel connects the reservoir to the abdominal surface. A small catheterizable stoma is placed in a cosmetically suitable site. It is important that the person is able to see the stoma in order to insert the catheter easily.
Instead of a woman having to transfer to an appropriate surface, remove her lower clothes, cath, and then repeat the procedure backward, she inserts a catheter into a surgically-created abdominal opening (stoma). The catheter passes into a created reservoir (or the natural bladder) to drain the urine while sitting in her chair.
Sounds simple, huh? Well it is still a surgical procedure, which involves being put to sleep by an anesthesiologist and pain during recovery. An indwelling Foley catheter will be utilized until healing is completed, which takes a few weeks. Once your stoma is ready for use, you will be trained on the new equipment.
This procedure is not for everyone, but it has been especially successful in women who have difficulty with self-catheterizations through the urethra and in people with recurrent and severe autonomic dysreflexia related to their bladder. Is it designed only for women? No, hence the mention of people with recurrent AD related to their bladder.
Ask your personal urologist if this is a feasible option.
• The Mitrofanoff Procedure, New Mobility, August 2010
• To Spigot or Not to Spigot, New Mobility, February 2006
• Mitrofanoff … Everything You Need to Know, Urostomy Association
• Mitrofanoff Procedure, Craig Hospital
• The Mitrofanoff Procedure, StomaData
A registered nurse since 1983, Patty Kunze holds a bachelor’s of science degree in nursing and worked several years in a Spinal Cord Injury Unit at the local Veterans Administration Medical Center as a new graduate. She has been a flight transport nurse for neonatal intensive care, an assistant manager of labor and delivery, and an instructor of nursing students. In 2009, she was involved in an auto accident that left her a T3-4 complete paraplegic, But she continues her nursing career while sitting in her wheelchair as a nurse paralegal and writing articles for others with spinal cord injuries as The Rollin RN.