Yang-Monti’s Catheterizable Stoma in Children

authors:

avatar Rajendra Bapusaheb Nerli 1 , * , avatar Shivagouda Malgouda Patil 1 , avatar Murigendra Basayya Hiremath 1 , avatar Mallikarjun Reddy 1

Department of Urology, KLES Kidney Foundation, JN Medical College, KLE University, Belgaum, India

how to cite: Bapusaheb Nerli R, Malgouda Patil S, Basayya Hiremath M, Reddy M. Yang-Monti’s Catheterizable Stoma in Children. Nephro-Urol Mon. 2013;5(3):e93985. 

Abstract

Background: In 1981, Mitrofanoff described a procedure to create a continent urinary stoma for clean intermittent catheterization. Since then several procedures have been described including Yang-Monti ileovesicostomy for effective catheterization.
Objectives: We report on our experience from the use of Monti’s procedure in children at our center.
Patients and Methods: Children < 18 years of age undergoing urinary diversion/reconstruction with Yang-Monti’s procedure for congenital conditions or neuropathic bladder formed the study group. All these children, post-operatively were taught clean intermittent catheterization (CIC) and put on a regime using a 14/16 Fr catheter every 3 hours. The children were followed regularly at 3, 6, 12, 18 and 24months post-operatively, with special attention paid to any problems with catheterization and incontinence.
Results: During the period from Jan 2000 to Dec 2011, at our center, 19 children less than eighteen years of age underwent urinary diversion with Yang-Monti’s catheterizable stoma. The indications for urinary diversion was neuropathic bladder in eight, exstrophy bladder in seven , valve bladder syndrome in three and persistent urethral stricture in one. None of the children found CIC difficult during the post-operative period and there was no hindrance to the passage of the catheter.
Conclusions: Although the appendix remains the tissue of choice for creation of catherterizable stoma, the Yang-Monti ileovesicostomy is effective, convenient conduit for children. Long-term complications are minimal and children find this comfortable to do CIC.

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References

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