ABSTRACT
Mitrofanoff reported the use of appendix implanted into the bladder as a continent catheter conduit in 1980.1 In this series the bladder neck was routinely closed to achieve continence. The appendix was first used as a continent catheterizable channel in children in the USA at the Children’s Hospital of Philadelphia in 1982 and was subsequently named by Drs John W Duckett and Howard M Snyder, III as the ‘Mitrofanoff principle’.2 Since then, many institutions have reported application of the appendicovesicostomy using the Mitrofanoff principle in the pediatric population,2-9 and it has become the most widely used alternative continence mechanism in the world.3-6,10,11 It has been used in exstrophy and epispadias patients who are reluctant to perform intermittent catheterization due to a sensitive urethra. It is also useful in spina bifida patients who may find it difficult to access their urethra due to obesity or wheelchair dependence. Mitrofanoff originally reported the use of either the appendix or ureter as the catheterizable channel and others have reported their use of ileum, fallopian tube, cecum and stomach.7,8,12 Furthermore, this technique has also been applied to reconstructive surgery in adults, and for achieving a continent stoma for antegrade enemas.13
