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Case Reports
. 2021 Jun 27;21(1):93.
doi: 10.1186/s12894-021-00861-0.

Transvaginal closure of urinary bladder opening and Mitrofanoff technique in a neurologically impaired female with chronic indwelling catheter: a case presentation

Athanasios Zachariou  1   2 , Minas Paschopoulos  3 , Aris Kaltsas  4 , Fotios Dimitriadis  5 , Athanasios Zikopoulos  4 , Charalampos Mamoulakis  6 , Atsushi Takenaka  7 , Nikolaos Sofikitis  4
Affiliations
Case Reports

Transvaginal closure of urinary bladder opening and Mitrofanoff technique in a neurologically impaired female with chronic indwelling catheter: a case presentation

Athanasios Zachariou et al. BMC Urol. .

Erratum in

Abstract

Background: Chronic catheterization remains the only attractive option in specific circumstances, especially in neurologically impaired patients. Complications produced by the indwelling catheters, like patulous urethra and bladder neck destruction, usually lead to severe incontinence and significant nursing difficulties. Here, we describe a rare case, a urinary bladder opening representing massive and extensive destruction of the urethra and bladder sphincter due to an indwelling catheter.

Case presentation: We present a 46-year-old paraplegic woman complaining of recurrent febrile urinary tract infections and severe urinary incontinence. She suffered from persistent malodorous urine and skin breakdowns from constant urine leakage. The vaginal examination revealed extensive destruction of the urethra and a 10 cm opening permitting the urinary bladder wall to prolapse into the vagina. The patient underwent a combined surgical approach; a transvaginal bladder closure with anterior colporrhaphy and a Mitrofanoff procedure to ensure a continent stoma for future clean intermittent self-catheterization (CISC). The patient is compliant with CISC and, remains continent twelve years after surgery.

Conclusion: This case demonstrates that in the era of CISC, there are still neurologically impaired females suffering from rare but critical adverse effects of indwelling catheters. The urethra and bladder neck erosion represent a demanding treatment assignment. The Mitrofanoff procedure for continent stoma and the transvaginal closure of urinary bladder opening produced a lifesaving potential treatment.

Keywords: Case report; Indwelling catheter; Mitrofanoff; Transvaginal urethral closure; Urethral damage.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The vaginal examination revealed destruction of the urethra
Fig. 2
Fig. 2
The vaginal examination revealed a 10 cm opening permitting the urinary bladder wall to prolapse into the vagina
Fig. 3
Fig. 3
The Mitrofanoff continent stoma
See this image and copyright information in PMC

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