The operation itself
The operation creates a channel between the bladder and the wall of the abdomen to allow urination via a catheter
Ideally the Mitrofanoff is created from the appendix (or small bowel). A section of the large bowel or fallopian tube can also be used.
One end is tunnelled into the wall of the bladder to create a valve
The other end is passed through an opening in the abdomen to form a small stoma through which a catheter can be passed to empty the bladder
The Mitrofanoff is often situated on the right-hand side of the lower abdomen, or in the umbilicus.
Bladder enlargement or replacing a bladder:
It is quite common that the bladder will need to be enlarged during the Operation. There are two options:
Bladder augmentation using part of the bowel - this is to enlarge a small bladder to create a sufficient reservoir for urine
Neobladder - the bladder is replaced by a completely new bladder (neobladder) made from part of the bowel. This is usually required when the individual has conditions such as cancer and the entire bladder needs to be removed.
When it is time for you to go to theatre the nurse and the hospital porter will take you to the anaesthetic room.
The nurse and hospital porter will then leave you with the anaesthetist and their assistant. If you have opted for an epidural infusion this will be administered, a needle will be put into your hand or arm where the general anaesthetic will be administered. The other lines, drips, etc. will be put in once you are asleep.
If you have already had your appendix removed or if it is not suitable, the surgeon may need to use a piece of the small bowel to create the urethra or even a fallopian tube.
The surgeon will disconnect your appendix from its usual position on the small bowel and open it up to form a tube. It will then be connected one end to a small incision in the bladder and the other end to another small incision in your abdomen. The surgeon will then create a valve where the tube joins the bladder, which squeezes shut as the bladder fills with urine. This will reduce the chance of urine leaking from the stoma.
If the capacity of the bladder is too small or needs to be removed because it is diseased, the surgeon will have to take some bowel to increase the size of the bladder.
You will be away from the ward for approximately 3 – 6 hours, although it may take longer if you are having other procedures in-conjunction with this, such as bladder augmentation.