Bowel and bladder function are controlled by nerves which come from the lowest levels of the spinal column. Therefore, almost all people with Spina Bifida will have trouble controlling their bowel and bladder function.
Without sensation, your child’s bladder may not know when it is full or be able to empty itself fully. If urine remains in the bladder the risk of infection increases and can also cause increased pressure on the kidneys. The muscle controlling the bladder outlet may also be weaker than normal, causing urine to dribble out slowly most of the time.
Mitrofanoff Procedure for Bladder Control
A surgical option for children with Spina Bifida to achieve bladder control is the Mitrofanoff procedure, which assists people who cannot empty their bladder completely as normal.
In the Mitrofanoff procedure one end of the appendix is connected to the bladder and the other end to the wall of the abdomen, either into the navel or below waist level.
The small opening (called a stoma) is used to pass a catheter into the bladder so it can be emptied. After the operation a catheter is placed in the stoma and will remain there for up to six weeks to drain urine from the bladder. After this period you will be taught how to catheterise the bladder through the stoma. Catheterisation via Mitrofanoff is not a sterile procedure, but is a clean one.
Catheterisation should be performed every four hours during the day. If this is not done the bladder may overfill, increasing the risk that it could burst.
As with any surgery, sometimes problems do occur. The stoma can occasionally become narrowed (stenosed). If it becomes difficult to catheterise, this could be the reason. If this happens it is important for you to contact your doctor or specialist nurse immediately.