Small procedures, lasting impact
The Mitrofanoff procedure is a simple yet ingenious concept that creates a passageway for the easy removal of urine in patients who self-catheterize.
Every so often, I will come across a medical procedure that will thoroughly impress me. I am always amazed and excited to see what advancements in the medical world are allowing humans to do. Recently, I met a person who taught me about a procedure I had never heard of. It is called the Mitrofanoff procedure, and it has changed her life.
The Mitrofanoff procedure was developed by Paul Mitrofanoff. It is a simple yet ingenious concept where the appendix is separated from the cecum, while blood flow is maintained to the appendix, and then the appendix is attached to the bladder and the umbilicus. This creates a passageway for the easy removal of urine. The patient is able to insert a catheter into the navel, creating a simple and effective way to self-catheterize.
After learning about this procedure, I decided that I needed to know more and I researched this topic extensively. Through my research of this procedure, I learned that it is great for patients who have difficulty catheterizing, such as in those with urethral masses, where catheterizing can be difficult, or in those with neurogenic bladders, where catheterizing can be painful. It is also life-changing for people with disabilities who are unable to easily self-catheterize.
After talking to this person who underwent Mitrofanoff procedure, I learned that it was life-changing for her because of her physical disabilities. Trying to catheterize herself was impossible in a public bathroom — where balancing herself over a toilet created a dangerous and unsanitary situation. The only truly successful way to self-catheterize was to lay down on the floor — another impossible situation when out in public. Therefore, this person was limited in what she could do. She couldn't go to many friends' houses as a child, and she had to plan all of her activities around being home at specific times to catheterize. The Mitrofanoff procedure completely changed her world. After the procedure, she was able to go on her first trip to an amusement park with her friends, and now she can use public restrooms without any issues. She doesn't have to plan her day around getting home in time to catheterize.
Hearing stories about procedures such as this one always make me happy. I often take for granted the ability to use a public restroom or to leave my house for the day to run errands with no set schedule in mind. It is easy to forget that for some people this is something they cannot do easily. We often hear about procedures that allow a person to walk again, allow a person to hear again, etc. But it is always great to hear about the advancements in medicine that are small in nature, but give a person the freedom to lead a normal life.
Jillian Knowles, MMS, PA-C is an emergency medicine physician assistant in the Philadelphia area.
- Veeratterapillay R, Morton H, Thorpe AC, Harding C. Reconstructing the lower urinary tract: The Mitrofanoff principle. Indian J Urol. 2013;29(4):316-21.
- Mitrofanoff Support. Mitrofanoff Procedure. http://www.mitrofanoffsupport.org.uk/mitrofanoff-procedure/. Accessed June 18, 2017.