ABSTRACT
PURPOSE: The Mitrofanoff continent catheterizable stoma is a useful technique in continent reconstruction. Continence is dependent on the formation of a valve mechanism usually in the form of a submucosal tunnel. This mechanism requires careful dissection of the appendix mesentery and may not be appropriate in small bowel pouches, The split cuff nipple technique has been used effectively for ureteral reimplantation into bowel segments, This paper describes the successful combination of these techniques to provide a continent catheterizable stoma. MATERIALS AND METHODS: Five patients(6 cases) have undergone split cuff nipple stoma formation. Appendix was used in 5 cases and ileum was used in 1 case. Underlying disease were 3 bladder cancers and 2 spinal cord injuries. Reservoir was made using 3 patients ileum, 1 right colon and 1 ileocolon. In 3 cases the appendix was brought out through the umbilicus and in another 3 cases the stoma was formed in the right iliac fossa. CONCLUSIONS: The split cuff nipple appendix stoma provides a simple and reliable continent stoma technique, overcoming some of the complexities of reimplantation of the intact appendix. The technique may be suitable for other narrow tubes, mainly the stapled small bowel or gastric tube.