The Mitrofanoff principle for continent urinary diversion.

The term Mitrofanoff describes a system for making a continent supra-public conduit into any reservoir for self-catheterisation. It requires a narrow tube, the commonest source of which is the appendix. Alternatively, the ureter, the Fallopian tube or a length of tailored intestine may be used. The tube is buried in the wall of the conduit in a tunnel about 5 cm long. There is no statistically significant difference in the results between any patient diagnosis, source of narrow tube or type of reservoir. About 90% of patients are continent. Up to 30% may have conduit complications, particularly stenosis at the skin level. Of the several systems of continent diversion available, the Mitrofanoff seems to be the easiest to learn and the most reliable.