✦ Urinary Diversion Treatment

Mitrofanoff Procedure (Appendicovesicostomy)

Q: What happens if I don't have an appendix?

If the appendix is absent or unsuitable, a Yang-Monti procedure uses a short segment of ileum reconfigured into a catheterisable tube of identical function.

Q: How often do I need to catheterise through the Mitrofanoff?

Most patients catheterise every 3–4 hours during the day using a 12 Fr catheter — approximately 5–6 times per 24 hours.

Q: Is the Mitrofanoff stoma visible?

When sited at the umbilicus, the Mitrofanoff stoma is completely hidden — indistinguishable from a normal umbilicus when not in use.

Continent catheterisable stoma using the appendix for clean intermittent catheterisation

3–5 Hours PROCEDURE

7–14 Days HOSPITAL STAY

>90% SUCCESS RATE

4–6 Weeks RECOVERY

What is Mitrofanoff Procedure (Appendicovesicostomy)?

The Mitrofanoff Procedure creates a continent catheterisable channel between the bladder and the abdominal skin surface using the appendix (appendicovesicostomy). The appendix is detached from the caecum, preserving its blood supply, and reimplanted into the bladder through a submucosal tunnel that acts as a continence mechanism. Patients catheterise through a flush abdominal stoma every 3–4 hours — no urine leaks between catheterisations. It enables bladder management without urethral catheterisation in patients with neurogenic bladder, urethral problems, or severe disability. The procedure is performed under general or spinal anaesthesia with a hospital stay of 7–14 Days.

Patients who need clean intermittent catheterisation but cannot catheterise urethrally — due to neurological conditions, urethral obstruction, wheelchair dependence, or body image preference for abdominal catheterisation over urethral access.

How the Procedure Works

Appendix Mobilisation

The appendix is identified and its blood supply from the appendicular artery assessed and preserved.

Bladder Preparation

The bladder is opened through a midline cystotomy or lower abdominal incision.

Submucosal Tunnel Creation

A 3–4 cm submucosal tunnel is created in the posterior bladder wall to accept the appendix tip.

Appendix Reimplantation

The tip of the appendix is drawn through the submucosal tunnel and anastomosed to the bladder mucosa.

Stoma Maturation & Closure

The appendix is brought to the umbilicus or right iliac fossa through the abdominal wall and matured as a flush continent stoma.

Outcomes

3–5 HoursDURATION

7–14 DaysHOSPITAL STAY

>90%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Children and adults with spina bifida, spinal cord injury, or neurogenic bladder requiring lifelong catheterisation.
→Wheelchair users who find urethral catheterisation physically difficult and prefer abdominal access.
→Patients with urethral stricture, trauma, or other pathology preventing urethral catheterisation.
→Women with neuropathic incontinence who cannot access their urethra independently.
→Those who want continence and the ability to catheterise discreetly through a hidden stoma.
→Patients undergoing bladder reconstruction (augmentation cystoplasty) who will need a catheterisable stoma.

"The Mitrofanoff procedure gives patients with neurogenic bladder a life-changing degree of independence. Being able to manage your own bladder discreetly, through a hidden stoma, without any external equipment — the impact on quality of life is profound."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

What happens if I don't have an appendix?+

How often do I need to catheterise through the Mitrofanoff?+

Is the Mitrofanoff stoma visible?+

Not sure which treatment is right for you?

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