What does the procedure involve?
This is a procedure to create a channel (for catheterisation) between the skin and either the bladder or a urinary reservoir. This is likely to be done (but not always) in conjunction with another procedure (either enlarging the bladder with a bowel patch or creating a urinary reservoir). This information sheet should be read in conjunction with the relevant information sheet for any other procedure.
What are the alternatives to this procedure?
Use of a catheter via the urethra (water pipe) or a urinary stoma with a bag.
What should I expect before the procedure?
You will usually be admitted on the same day as your surgery. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, and the your named nurse. You will be asked not to eat or drink for 6 hours before surgery.
You will be given an injection under the skin of a drug (tinzaparin) which, together with the help of elasticated stockings provided by the ward, will help prevent thrombosis (clots) in the veins of your legs.
What happens during the procedure?
A full general anaesthetic (where you will be asleep throughout the procedure) will be used. The channel will be created using the appendix (if you still have one), a short segment of small intestine (ileum) or a combination of both. It will be joined to the skin by a flap fashioned into a small pit, rather like a second umbilicus (navel).
What happens immediately after the procedure?
You may experience discomfort for a few days after the procedure but painkillers will be given to you on the ward and, later, to take home. Absorbable stitches are normally used on the skin flap and these do not require removal.
A catheter will have been inserted into the channel, together with one or two catheters into the bladder or urinary reservoir, to promote drainage and to allow the suturing to heal up completely.
You will probably be able to go home, once you are mobile, with the catheters in place, having been taught how to manage them. You will be re-admitted 3 weeks after the operation for removal of these catheters and to be taught how to pass a catheter into the Mitrofanoff stoma. The average hospital stay is 2 weeks.
Are there any side-effects?
Most procedures have a potential for side-effects. You should be reassured that, although all these complications are well-recognised, the majority of patients do not suffer any problems after a urological procedure.
The channel may become narrowed, requiring either a catheter to be left for about two weeks or, possible, further surgery to correct the problem. The channel may not hold urine without leakage, leading to further surgery to correct the problem.
Rarely, you may develop anaesthetic or cardiovascular problems possibly requiring intensive care admission (including chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack and death).
What should I expect when I get home?
When you leave hospital, you will be given a “draft” discharge summary of your admission. This holds important information about your inpatient stay and your operation.
If, in the first few weeks after your discharge, you need to call your GP for any reason or to attend another hospital, please take this summary with you to allow the doctors to see details of your treatment. This is particularly important if you need to consult another doctor within a few days of your discharge.
It will be at least 6 weeks before full healing occurs and you may return to work when you are comfortable enough and your GP is satisfied with your progress.
What else should I look out for?
If there is any difficulty passing a catheter into the Mitrofanoff channel, please contact your named nurse. If you experience fever or vomiting, especially if associated with unexpected pain in your abdomen, you should contact your GP immediately for advice.
Are there any other important points?
A follow-up outpatient appointment will be arranged for you some 10-12 weeks after the operation. You will receive this appointment either whilst you are on the ward or shortly after you get home.
