Functional and cosmetic outcome of the VQ plasty for Mitrofanoff stomas.

Abstract

A skin lined Mitrofanoff stoma in the iliac fossa is traditionally achieved using a VQZ technique, providing a channel for intermittent catheterization. We simplified our approach by using a VQ flap at the distal end of the Pfannenstiel incision. We present a comparison of the functional and cosmetic outcome of these 2 approaches. Records of all patients requiring a Mitrofanoff stoma performed by a single surgeon (RS) were reviewed. Data were collected from hospital notes, patient followup clinics and urology nurse specialist records. All VQ type stomas were performed since March 2004. A total of 21 patients had 23 stomas formed (11 VQZ and 12 VQ plasty). Each group was composed mainly of appendiceal conduits. Three ileal (Monti) conduits were formed. Mean followup was 18.3 months for VQZ and 15 months for VQ cases. Removing the Z flap leaves behind a neat skin lined stoma unlike a VQZ plasty, which results in a more prominent and irregular scar. One VQ stoma prolapsed slightly. Three stomas were revised in the VQZ group for stenosis (1 traumatic) or leakage, 2 using VQ plasty. Formation of a skin lined stoma by VQ plasty as opposed to VQZ plasty reduces scarring around the conduit without affecting the complication rate or stoma continence. Patients continue to be positive about the cosmetic appearance of the stoma.