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Outcomes of urinary diversion in children with spinal cord injuries Merenda LA; Duffy T; Betz RR; Mulcahey MJ; Dean G; Pontari MJ Spinal Cord Med 2007[]; 30 Suppl 1 (Suppl 1): S41-7PURPOSE: To gain a better understanding of the outcomes of the Mitrofanoff procedure for urinary diversion in children with spinal cord injury (SCI). DESIGN: Descriptive retrospective. PARTICIPANTS/METHODS: Individuals 6 to 27 years of age with SCI with at least 1 year follow-up after the Mitrofanoff procedure. Objective data collected via retrospective chart review include general demographics and medical/surgical history. Data collected via structured telephone interview include history of adverse urological events, bladder management, bladder management independence scores, patient satisfaction, and quality of life. RESULTS: Sixteen subjects (13 female, 3 male) with a mean age of 19 years (range 6-27 y) who underwent the Mitrofanoff procedure were interviewed. Length of postoperative follow-up ranged from 1 to 8 years (mean 4.25 y). Complications included stomal stenosis 25% (n=4) with a mean of 19 months to first occurrence of stenosis; urethral incontinence 75% (n=12); renal/bladder calculi 19% (n = 3); and stomal leakage 44% (n=7). Independence scores for bladder management after the Mitrofanoff procedure improved in 84% of subjects with tetraplegia and 25% of subjects with paraplegia. Eighty-eight percent (n 14) were satisfied with the procedure, while 12% (n=2) were somewhat satisfied. A thematic analysis of quality of life revealed that freedom (35%) and independence (35%) were most commonly cited. CONCLUSION: While some subjects experienced complications, satisfaction was relatively high and level of independence in bladder management was greatly improved. This study demonstrates that the Mitrofanoff procedure is a beneficial option to improve independence and ease of bladder management in children with SCI.|*Cystostomy/adverse effects/psychology[MESH]|*Treatment Outcome[MESH]|*Urinary Catheterization/adverse effects/psychology[MESH]|Adolescent[MESH]|Adult[MESH]|Child[MESH]|Female[MESH]|Humans[MESH]|Interviews as Topic[MESH]|Longitudinal Studies[MESH]|Male[MESH]|Patient Satisfaction[MESH]|Quality of Life[MESH]|Retrospective Studies[MESH]|Spinal Cord Injuries/*complications/surgery[MESH]|Urination Disorders/*etiology/psychology/*surgery[MESH] |
