Is Mitrofanoff surgery the right option for a boy, 10 with BBS?

Question

Hi doctor,

A 10-year-old boy was already diagnosed with Bardet- Biedl syndrome (BBS), CKD (chronic kidney disease), hypogonadism, and neurogenic bladder complained of recurrent urinary tract infection and constipation. The child got Mitrofanoff appendicovesicostomy ten days back. I have attached the discharge summary and all relevant documents (present and past medical history along with the surgery done). I want a second opinion on the treatment done and prognosis. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I went through the discharge summary (attachment removed to protect patient identity). I understand that appendicular mitrofanoff was done after the diagnosis of the Neurogenic bladder.

I want to let you know that mitrofanoff is the surgery in cases of neurogenic bladder. So, if the diagnosis is confirmed beyond doubt, then the surgery done is appropriate. Please send me the ultrasound reports and MRI (magnetic resonance imaging) and the urodynamic study if done.

Regarding the prognosis - The neurogenic bladder is never going to get cured. So there is no permanent cure for it. They can be managed only by lifestyle adjustments and surgeries like Mitrofanoff and bladder augmentation with bladder neck repair.