Video bank| Volume 8, ISSUE 4, P437.e1-437.e2, August 2012

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An alternative channel for the Mitrofanoff principle based on transverse skin flaps: An extraperitoneal minimal invasive approach (the RPM technique)



      The Mitrofanoff principle is a well established strategy in pediatric urology, with the appendix and Yang-Monti tube being the most used channels. The search for an alternative tube with less morbidity is justified. Hence, we present a patient treated via an alternative approach in which the channel was constructed from two lower abdominal transverse skin flaps (the RPM technique).


      A 17-year-old patient with posterior urethral valves, hypocontractile bladder and experiencing pain on urethral clean intermittent catheterization was selected. The procedure consisted of defining two rectangular transverse skin flaps of 5 × 1 cm opposite to each other. The flaps were rotated 90° and anastomosed to create a tube. A small extraperitoneal bladder wall incision was performed and the tube was connected to the bladder. Two rectal abdomen muscle strips were crossed in the midline as a neosphincter.


      The patient had an uneventful postoperative course and remains continent for intervals of 4 h. The stoma and incision have a good cosmetic aspect at 16 months follow-up.


      The RPM technique is an alternative approach for a minimal invasive strategy according to the Mitrofanoff principle. Long-term follow-up is necessary to confirm the excellent initial results.


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        • Mitrofanoff P.
        Trans-appendicular continent cystostomy in the management of the neurogenic bladder.
        Chir Pediatr. 1980; 21: 297
        • Monti P.R.
        • Lara R.C.
        • Dutra M.A.
        • de Carvalho J.R.
        New techniques for construction of efferent conduits based on the Mitrofanoff principle.
        Urology. 1997; 49: 112
        • Macedo Jr., A.
        • Srougi M.
        A continent catheterizable ileum-based reservoir.
        BJU Int. 2000; 85: 160
        • Macedo Jr., A.
        • Rosito T.
        • Pires J.A.
        • Liguori R.
        • Ortiz V.
        A new extra-abdominal channel alternative to the Mitrofanoff principle: experimental and preliminary clinical experience.
        Int Braz J Urol. 2009; 35: 205
        • Pons M.
        • Messaoudi R.
        • Fiquet C.
        • Jolly C.
        • Chaouadi D.
        • Lefebvre F.
        • et al.
        Use of cutaneous flap for continent cystostomy (daoud technique).
        J Urol. 2010; 184: 1116

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