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MitrofanoffMMitrofanoffMitrofanoffEnglishUrologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Appendix;BladderBladderProceduresCaregivers Adult (19+)NA2009-11-10T05:00:00ZDalia Bozic, RN, BScN;Catherine Daniels, RN, MS, ACNP;Lisa McGrath, RN6.0000000000000070.00000000000001743.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A mitrofanoff is a surgical procedure that creates an opening from the bladder to outside the body. Learn about how and why mitrofanoff is used.</p><h2>What is a Mitrofanoff?</h2><p>A Mitrofanoff (say: me-TROFF-an-off) is a small tunnel from the bladder to the outside of the body. This tunnel is used to empty the bladder with a catheter. A catheter is a small flexible tube that is put into the bladder through the Mitrofanoff. </p> <figure><span class="asset-image-title">Mitrofanoff</span><img src="https://assets.aboutkidshealth.ca/akhassets/Mitrofanoff_MED_ILL_EN.jpg" alt="" /><figcaption class="asset-image-caption">A Mitrofanoff is a surgical procedure that creates a small tunnel from the bladder to the outside of the body.</figcaption></figure> <p>There are many reasons a child may need a Mitrofanoff, such as:</p><ul><li>birth defects </li><li>injury </li><li>cancer </li><li>trouble or pain with using a catheter through the urethra. The urethra is the tube that normally carries urine (pee) out of the bladder. </li></ul><p>A Mitrofanoff is created with surgery (an operation). To make the tunnel, the surgeon will use your child's appendix. The appendix is an unused part of the bowel. The surgeon will take it and re-attach it between your child's bladder and the skin of the belly. This whole procedure is sometimes called a Mitrofanoff procedure or catheterization using a Mitrofanoff. </p><p>Use the information on this page to explain to your child what will happen, using language your child understands.</p><h2>Key points</h2> <ul> <li>A Mitrofanoff is a tunnel between the bladder and the outside of the body. This tunnel is used to pass urine through a catheter. </li> <li>Your child will need an operation to make the Mitrofanoff. </li> <li>After the operation, your child may have other catheters. They will be removed later. </li> <li>Your child may have bladder spasms for a few days after the surgery. </li> <li>When your child's Mitrofanoff has healed, a nurse will teach you and your child how to use the catheter. </li> </ul><h2>The day of the operation</h2> <p>The day of the operation, your child will be pre-admitted at the Urology Unit. Your child can have only clear liquids to drink.</p> <p>Your child will be given another enema.</p> <p>Your child will be given a special "sleep medicine" called a general anesthetic during the operation. This means that your child will sleep and will feel no pain during the procedure. </p> <p>Mitrofanoff surgery usually takes about two hours. Your surgeon will speak to you about this before the surgery.</p><h2>After the operation</h2> <p>When your child goes back to the unit from the operating room, they will have an intravenous line (IV). An IV is a tiny plastic tube that is placed in a vein in the hand or arm. For the first few days after the operation, your child will get the liquids and medicines they need through the IV. </p> <p>Your child will may also have some of the following.</p> <h3>Nasogastric tube</h3> <p>Your child will have a nasogastric tube. The tube usually stays in place for about one week. Your child's stomach must stay empty and have a chance to rest after the operation. </p> <h3>Suprapubic catheter</h3> <p>Your child will have a suprapubic catheter after the operation. This catheter is a small tube that goes through the skin of the belly into the bladder. All the urine that would normally be stored in the bladder drains out through this tube and into a bag called a urine collection bag. </p> <p>This catheter will be taken out at the urology clinic, usually about one week after the Mitrofanoff operation. Your child will not need an operation to take out the catheter. </p> <h3>Stents</h3> <p>Your child may have ureteral stents. These are small plastic tubes that sit in the ureters. The ureters are the tubes between the kidneys and the bladder. The ureteral stents let all the urine drain from the kidneys and give your child time to heal. </p> <p>Your child will need an operation to take out the stents, usually six to eight weeks after the Mitrofanoff operation.</p> <h3>Urinary catheter</h3> <p>Your child will have a urinary catheter inside the Mitrofanoff. It may or may not be attached to a urine collection bag.</p> <h3>Incision, stitches and gauze</h3> <p>Your child's incision will be closed with stitches. The incision is the place where the surgeon cuts through the skin to operate. The stitches will dissolve about 10 days after the operation. </p> <p>The incision and the stitches will be covered with white gauze. The nurse will change the gauze every day.</p> <h3>Penrose drain</h3> <p>A drain called a Penrose drain may be placed in your child's belly, close to the incision. It takes away the extra liquids that may collect during the operation. This drain looks a lot like a thick elastic band. It will be stitched in place and covered with a piece of gauze. </p> <p>We will take out this drain before your child goes home.</p> <h2>Managing your child's pain</h2> <p>There are several ways to control pain that work well. Which way we use will depend on your child's age and needs.</p> <ul> <li>Your child may get medicine for pain through the IV. </li> <li>Your child may have an epidural catheter. An epidural catheter is a small plastic tube that an anesthesiologist puts into a space in the spine. (The anesthesiologist is the doctor who gives sleep medicine to take away the pain.) The catheter is put in in the operating room. This catheter lets your child have medicine for pain all the time. The epidural catheter works well because it numbs the body below the incision. </li> <li>Once your child feels better, they can swallow their pain medicine. </li></ul> <h2>The cause and treatment of bladder spasms</h2> <p>Catheters and stents may bother the bladder and cause cramps, called bladder spasms. Sometimes bladder spasms can hurt a lot. If your child has painful bladder spasms, they will be given a medicine called a B&O suppository. This medicine relaxes the bladder and reduces the pain. </p> <h3>Symptoms of bladder spasms</h3> <p>Signs that your child is having bladder spasms may include:</p> <ul> <li>pain that comes on quickly and then stops </li> <li>an itchy bottom </li> <li>the need to urinate or have a bowel movement (poo) often </li> <li>your child holding or rubbing their genitals (private parts) more than usual </li> <li>urine leaking around the catheter </li> <li>drawing the knees up to the chest, especially in babies and toddlers </li> </ul> <p>The nurse will check your child's pain control regularly. But you know your child best. The nurse will want to know if you think your child's pain is being controlled well. If you feel your child is in pain, tell the nurse. </p> <h2>Getting active again</h2> <p>Right after the operation, your child will have to stay in bed all day and all night. Your child may not be allowed to sit up for one or two days. While your child is lying in bed, they should try to do these things: </p> <ul> <li>take deep breaths and cough </li> <li>exercise their legs </li> <li>roll from side to side </li> </ul> <p>The nurse will help.</p> <p>The doctor will decide when your child is ready to get out of bed. Your child will have to become active slowly. Your child can start by sitting in a chair. Then they can slowly start to walk when they are ready. </p> <h2>Eating and drinking after the operation</h2> <p>Your child's bowel needs to rest after the operation. So your child will not be able to eat or drink for a while. When they begin to feel grumbling in the stomach and passes gas, the doctor will take out the nasogastric tube. </p> <p>Your child will be allowed only clear liquids at first. They can eat normal food after a few days.</p> <p>Your child must drink as much liquid as possible. This will help the catheters drain well.</p><h2>Preparing for the operation</h2> <p>Before any operation, patients often have to do specific things to prepare. Staff at the hospital will tell you what you need to do before the operation. They will give you a brochure or pamphlet to read. If you do not get this information, ask. If you have more questions after reading the pamphlet, ask. </p> <p>Because the surgeon will cut out your child's appendix, it is important to make sure that your child's bowel is as clean as it can be before the operation. Getting the bowel as clean as possible means restricting what your child eats and having enemas. </p> <h3>Eating and drinking</h3> <p>For two to three days before the operation, your child should only have clear fluids to drink. Clear fluids are liquids you can see through, like water, apple juice, ginger ale, Sprite, Jello and freezies. Your child cannot have anything else to eat or drink. </p> <p>Write the date of your child's operation here:</p> <p>Write the date your child must start having only clear fluids here:</p> <h3>Enemas</h3> <p>Your child will need to have several enemas. An enema means that a small tube is put into your child's anus and water is flushed inside. Then, your child will go to the bathroom and expel the water and feces (poo) from the bowel. Usually, enemas are a bit uncomfortable but they do not hurt. </p><h2>At SickKids</h2> <h3>Supporting your child</h3> <p>When preparing your child for an operation, the urology team recommends that whenever possible, your child and family members attend the Pre-Admission Program offered at SickKids. For more information call 416-813-6150 or visit the website at www.sickkids.ca </p> <p>A Child Life Specialist can also help to prepare and support your child if they are anxious about the operation.</p><h2>Useful websites</h2> <p><a href="http://www.sickkids.ca/" target="_blank">www.sickkids.ca</a> </p> <p><a href="/">www.aboutkidshealth.ca</a> </p> <p><a href="http://www.cua.org/" target="_blank">www.cua.org</a> </p>
MitrofanoffMMitrofanoffMitrofanoffFrenchUrologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Appendix;BladderBladderProceduresCaregivers Adult (19+)NA2009-11-10T05:00:00ZDalia Bozic, RN, BScN;Catherine Daniels, RN, MS, ACNP;Lisa McGrath, RN6.0000000000000070.00000000000001743.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Un mitrofanoff est une intervention chirurgicale qui crée une ouverture à partir de la vessie jusqu'à l'extérieur du corps. Vous apprendrez comment un Mitrofanoff.</p><h2>Qu’est-ce qu’un Mitrofanoff?</h2> <p>Un Mitrofanoff est un petit tunnel qui part de la vessie et qui sort du corps. Ce tunnel sert à vider la vessie ave​c un cathéter. Un cathéter, c’est un petit tube en plastique souple qui s’insère dans la vessie par le Mitrofanoff. </p> <figure> <span class="asset-image-title">Mitrofanoff</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Mitrofanoff_MED_ILL_FR.jpg" alt="" /> <figcaption class="asset-image-caption">Un Mitrofanoff est une intervention chirurgicale pendant laquelle on crée un tunnel entre la vessie et l'extérieur du corps..</figcaption> </figure> <p>Un enfant pourrait avoir besoin d’un Mitrofanoff pour diverses raisons, dont celles-ci:</p> <ul> <li>déformations de naissance;</li> <li>blessure;</li> <li>cancer ;</li> <li>problèmes ou douleur associés à l’utilisation d’un cathéter par l’urètre. L’urètre, c’est le tube qui transporte normalement l’urine hors de la vessie.</li> </ul> <p>Un Mitrofanoff est créé au moyen d’une opération. Pour faire le tunnel, le chirurgien utilisera l’appendice de votre enfant. L’appendice est une partie inutile de l’intestin. Le chirurgien l’attachera entre la vessie et la peau du ventre de votre enfant. Ce processus s’appelle parfois procédure de Mitrofanoff ou cathétérisme au moyen d’un Mitrofanoff. </p> <p>Servez-vous des renseignements contenus dans cette page pour expliquer à votre enfant ce qui se passera, en vous servant de langage que votre enfant comprendra.</p><h2>À retenir</h2><ul><li>Un Mitrofanoff est un tunnel entre la vessie et l’extérieur du corps. Ce tunnel sert à évacuer l’urine au moyen d’un cathéter.</li><li>Il faudra opérer votre enfant pour faire le Mitrofanoff.</li><li>Après l’opération, votre enfant pourrait avoir d’autres cathéters, qui seront retirés plus tard.</li><li>Votre enfant pourrait avoir des spasmes de la vessie pendant quelques jours après l’opération.</li><li>Quand le Mitrofanoff de votre enfant sera guéri, une infirmière vous enseignera ainsi qu’à votre enfant à utiliser le cathéter. </li></ul><h2>Le jour de l’opération</h2> <p>Le jour de l’opération, votre enfant sera préadmis à l’unité d’urologie. Votre enfant ne peut boire que des liquides clairs seulement.</p> <p>On fera un autre lavement à votre enfant.</p> <p>Votre enfant recevra un médicament pour l’endormir spécial, appelé anesthésique général pendant l’opération. Cela signifie que votre enfant dormira et ne ressentira aucune douleur pendant l’opération.</p> <p>La procédure de Mitofanoff prend habituellement deux heures. Votre chirurgien vous en parlera avant l’opération.</p><h2>Après l’opération</h2> <p>Quand votre enfant reviendra à l’unité des soins à partir de la salle d’opération, il aura une intraveineuse (IV). Une intraveineuse est un tube de plastique placé dans la veine de la main ou du bras. Pendant les premiers jours qui suivent l’opération, votre enfant aura les liquides et les médicaments dont il a besoin par l’IV. </p> <p>Votre enfant pourrait aussi avoir le matériel suivant.</p> <h3>Tube nasogastrique</h3> <p>Votre enfant aura un tube nasogastrique, qui reste en place pendant environ une semaine. L’estomac de votre enfant doit être vide et avoir une chance de se reposer après l’opération. </p> <h3>Cathéter sus-pubien</h3> <p>Votre enfant aura un cathéter sus-pubien après l’opération. Ce cathéter est un petit tube qui traverse la peau du ventre pour se rendre dans la vessie. Toute l’urine qui serait normalement stockée dans la vessie sort par ce tube et se dépose dans un sac appelé sac collecteur d’urine. </p> <p>Ce cathéter sera retiré à la clinique d’urologie, habituellement une semaine après la procédure de Mitrofanoff. Votre enfant n’aura pas besoin de se faire opérer pour faire retirer le cathéter.</p> <h3>Endoprothèses</h3> <p>Votre enfant pourrait avoir des endoprothèses urétrales. Ce sont de petits tubes de plastique qui se placent dans l’uretère. Les uretères sont les tubes situés entre les reins et la vessie. Les endoprothèses urétrales laissent couler toute l’urine qui provient des reins et donnent le temps à votre enfant à guérir. </p> <p>Votre enfant devra se faire opérer de nouveau pour faire retirer les endoprothèses, habituellement de six à huit semaines après la procédure de Mitrofanoff.</p> <h3>Cathéther urinaire</h3> <p>Un cathéter urinaire sera installé dans le Mitrofanoff de votre enfant. Il pourrait ou non être attaché à un sac collecteur d’urine.</p> <h3>Incision, points de suture et gaze</h3> <p>L’incision de votre enfant sera fermée à l’aide de points. L’incision, c’est où le chirurgien a coupé la peau pour opérer. Les points disparaîtront dans les 10 jours après l’opération environ. </p> <p>L’incision et les points seront couverts de gaze blanche. L’infirmière ira changer la gaze tous les jours.</p> <h3>Drain Penrose</h3> <p>Un drain appelé Penrose peut être placé dans le ventre de votre enfant. Ce drain évacue tout liquide qui peut s’accumuler pendant l’opération. Il ressemble beaucoup à un élastique épais et sera attaché et couvert d’un morceau de gaze.</p> <p>Nous retirerons ce drain avant que votre enfant ne retourne à la maison.</p> <h2>Gestion de la douleur de votre enfant</h2> <p>Il y a plusieurs moyens de contrôler la douleur qui fonctionnent bien. Le choix du moyen dépend de l’âge de votre enfant et de ses besoins.</p> <ul> <li>Votre enfant pourrait recevoir des médicaments contre la douleur par l’IV.</li> <li>Votre enfant peut avoir un cathéter épidural. Un cathéter épidural est un petit tube de plastique qu’un anesthésiste place dans une cavité de la colonne vertébrale (l’anesthésiste est le médecin qui donne le médicament qui endort, pour que l’opération soit sans douleur). Le cathéter est installé dans la salle d’opération. Il permet à votre enfant de recevoir des médicaments contre la douleur en tout temps. Le cathéter épidural est efficace parce qu’il désensibilise le corps en aval de l’incision.</li> <li>Une fois que votre enfant se sentira mieux, il pourra avaler les médicaments contre la douleur. </li></ul> <h2>La cause et le traitement des spasmes de la vessie</h2> <p>Les cathéters et les endoprothèses peuvent irriter la vessie et causer des crampes, appelées spasmes de la vessie. Parfois, ces spasmes peuvent être très douloureux. Si votre enfant a des spasmes de la vessie douloureux, on lui donnera des médicaments appelés suppositoires de B et O. Ce médicament détend les muscles de la vessie et réduit la douleur.</p> <h3>Symptômes de spasmes de la vessie</h3> <p>Voici des signes que votre enfant a des spasmes de la vessie :</p> <ul> <li>Douleur qui apparait et cesse soudainement;</li> <li>Démangeaisons au siège;</li> <li>Le besoin d’uriner ou d’aller à la selle souvent;</li> <li>Votre enfant touche ou frotte les parties génitales plus qu’à l’habitude;</li> <li>De l’urine s’écoule autour du cathéter;</li> <li>L’enfant colle ses genoux à la poitrine, surtout les bébés et les tout-petits.</li> </ul> <p>L’infirmière vérifiera le contrôle de la douleur de votre enfant régulièrement. Elle voudra savoir si vous pensez que la douleur de votre enfant est bien contrôlée. Si vous estimez que votre enfant a mal, dites-le à l’infirmière. </p> <h2>Retour à l’activité</h2> <p>Tout de suite après l’opération, votre enfant devra rester au lit toute la journée et toute la nuit. On pourrait ne pas lui permettre de s’asseoir avant une à jeux journées. Pendant que votre enfant est couché, il devrait essayer ceci :</p> <ul> <li>prendre de grandes respirations et tousser;</li> <li>bouger les jambes;</li> <li>se rouler sur les deux côtés.</li> </ul> <p>L’infirmière l’aidera.</p> <p>Le médecin décidera quand votre enfant sera prêt à sortir du lit. Il devra reprendre lentement ses activités physiques, en commençant par s’asseoir dans une chaise. Il peut ensuite recommencer lentement à marcher quand il sera prêt.</p> <h2>Manger et boire après l’opération</h2> <p>Les intestins de votre enfant doivent se remettre de l’opération. Votre enfant ne pourra donc ni manger ni boire pendant un certain temps. Quand son estomac commencera à faire du bruit et que votre enfant aura des gaz, le médecin retirera le tube nasogastrique. </p> <p>Votre enfant ne pourra boire que des liquides clairs au début. Il pourra recommencer à manger des aliments après quelques jours.</p> <p>Votre enfant doit boire autant de liquides que possible, car cela aidera le cathéter à bien évacuer les liquides.</p><h2>Préparation pour l’opération</h2> <p>Avant toute opération, les patients doivent souvent faire des choses précises pour se préparer. Le personnel de l’hôpital vous dira ce que vous devez faire avant l’opération. Il vous donnera une brochure ou un dépliant que vous pourrez lire. Si vous n’obtenez pas ces renseignements, demandez-les. Si vous avez d’autres questions après les avoir lus, posez-les. </p> <p>Étant donné que le chirurgien coupera l’appendice de votre enfant, il est important que l’intestin de votre enfant soit aussi propre que possible avant l’opération. Pour ce faire, il faut restreindre ce que l’enfant mange et utiliser des lavements. </p> <h3>Manger et boire</h3> <p>Pendant les deux à trois jours avant l’opération, vous enfant ne devrait boire uniquement que des liquides clairs. On entend par liquide clair des liquides transparents, comme l’eau, du jus de pomme, une boisson gazeuse au gingembre, du Sprite, du Jello et des sucettes glacées. Votre enfant ne peut manger ni boire rien d’autre. </p> <p>Écrivez la date de l’opération de votre enfant ici :</p> <p>Écrivez la date où votre enfant ne doit uniquement boire que des liquides clairs ici :</p> <h3>Lavements</h3> <p>Il faudra faire plusieurs lavements à votre enfant. Un lavement, c’est un petit tube que l’on insère dans l’anus de votre enfant, après quoi on y insère de l’eau. Par la suite, votre enfant se rend à la toilette et évacue les matières fécales de l’intestin. Habituellement, les lavements sont un peu inconfortables, mais ils ne sont pas douloureux. </p><h2>À SickKids</h2> <h3>Soutien à votre enfant</h3> <p>Quand vous préparerez votre enfant pour une opération, l’équipe d’urologie recommande que dans la mesure du possible, votre enfant et les membres de sa famille participent au programme préalable à l’admission à Sick Kids. Pour de plus amples renseignements, composez le 416-813-6150 ou visitez le site Web, à l’adresse www.sickkids.ca.</p> <p>Un spécialiste des enfants peut aussi aider à préparer et à soutenir votre enfant si l’opération l’inquiète. </p><h2>Sites Web utiles</h2> <p><a href="http://www.sickkids.ca/" target="_blank">www.sickkids.ca</a> </p> <p><a href="/">www.aboutkidshealth.ca</a> </p> <p><a href="http://www.cua.org/" target="_blank">www.cua.org</a> </p>

 

 

Mitrofanoff1007.00000000000MitrofanoffMitrofanoffMEnglishUrologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Appendix;BladderBladderProceduresCaregivers Adult (19+)NA2009-11-10T05:00:00ZDalia Bozic, RN, BScN;Catherine Daniels, RN, MS, ACNP;Lisa McGrath, RN6.0000000000000070.00000000000001743.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A mitrofanoff is a surgical procedure that creates an opening from the bladder to outside the body. Learn about how and why mitrofanoff is used.</p><h2>What is a Mitrofanoff?</h2><p>A Mitrofanoff (say: me-TROFF-an-off) is a small tunnel from the bladder to the outside of the body. This tunnel is used to empty the bladder with a catheter. A catheter is a small flexible tube that is put into the bladder through the Mitrofanoff. </p> <figure><span class="asset-image-title">Mitrofanoff</span><img src="https://assets.aboutkidshealth.ca/akhassets/Mitrofanoff_MED_ILL_EN.jpg" alt="" /><figcaption class="asset-image-caption">A Mitrofanoff is a surgical procedure that creates a small tunnel from the bladder to the outside of the body.</figcaption></figure> <p>There are many reasons a child may need a Mitrofanoff, such as:</p><ul><li>birth defects </li><li>injury </li><li>cancer </li><li>trouble or pain with using a catheter through the urethra. The urethra is the tube that normally carries urine (pee) out of the bladder. </li></ul><p>A Mitrofanoff is created with surgery (an operation). To make the tunnel, the surgeon will use your child's appendix. The appendix is an unused part of the bowel. The surgeon will take it and re-attach it between your child's bladder and the skin of the belly. This whole procedure is sometimes called a Mitrofanoff procedure or catheterization using a Mitrofanoff. </p><p>Use the information on this page to explain to your child what will happen, using language your child understands.</p><h2>Key points</h2> <ul> <li>A Mitrofanoff is a tunnel between the bladder and the outside of the body. This tunnel is used to pass urine through a catheter. </li> <li>Your child will need an operation to make the Mitrofanoff. </li> <li>After the operation, your child may have other catheters. They will be removed later. </li> <li>Your child may have bladder spasms for a few days after the surgery. </li> <li>When your child's Mitrofanoff has healed, a nurse will teach you and your child how to use the catheter. </li> </ul><h2>Learning to use the catheter and Mitrofanoff</h2> <p>When your doctor feels that everything has healed, they may decide to send your child home for a short time. Your child will have these two catheters: </p> <ul> <li>a catheter in the Mitrofanoff </li> <li>a suprapubic catheter </li> </ul> <p>The nurse will teach you how to look after your child's catheters at home before you leave the hospital.</p> <p>Before you go home, we will arrange for a home care nurse to visit you at home. This nurse will help you and your child look after the catheters in your home. </p> <p>The doctor will decide when you should learn how to put a catheter into the Mitrofanoff to drain the urine. This is called catheterization. When you <a href="/Article?contentid=1008&language=English">learn to catheterize the Mitrofanoff</a>, your child will return to the hospital for a couple of hours. The nurse will teach you and your child how to do the catheterization. </p> <p>Most young children who go to school can catheterize their Mitrofanoff on their own. Many children can help care for their own Mitrofanoff, even children who are not going to school yet.</p> <h2>Telling your child's other doctors about the Mitrofanoff</h2> <p>Tell all doctors who take care of your child that they have a Mitrofanoff. Some doctors may not have heard of this before. You may have to explain it to them. </p> <p>You should also tell the school nurse that your child has a Mitrofanoff.</p> <p>Your child needs to wear a medic alert bracelet. Before your child leaves the hospital, the nurse will give you the forms to fill out to get this bracelet. </p><h2>The day of the operation</h2> <p>The day of the operation, your child will be pre-admitted at the Urology Unit. Your child can have only clear liquids to drink.</p> <p>Your child will be given another enema.</p> <p>Your child will be given a special "sleep medicine" called a general anesthetic during the operation. This means that your child will sleep and will feel no pain during the procedure. </p> <p>Mitrofanoff surgery usually takes about two hours. Your surgeon will speak to you about this before the surgery.</p><h2>After the operation</h2> <p>When your child goes back to the unit from the operating room, they will have an intravenous line (IV). An IV is a tiny plastic tube that is placed in a vein in the hand or arm. For the first few days after the operation, your child will get the liquids and medicines they need through the IV. </p> <p>Your child will may also have some of the following.</p> <h3>Nasogastric tube</h3> <p>Your child will have a nasogastric tube. The tube usually stays in place for about one week. Your child's stomach must stay empty and have a chance to rest after the operation. </p> <h3>Suprapubic catheter</h3> <p>Your child will have a suprapubic catheter after the operation. This catheter is a small tube that goes through the skin of the belly into the bladder. All the urine that would normally be stored in the bladder drains out through this tube and into a bag called a urine collection bag. </p> <p>This catheter will be taken out at the urology clinic, usually about one week after the Mitrofanoff operation. Your child will not need an operation to take out the catheter. </p> <h3>Stents</h3> <p>Your child may have ureteral stents. These are small plastic tubes that sit in the ureters. The ureters are the tubes between the kidneys and the bladder. The ureteral stents let all the urine drain from the kidneys and give your child time to heal. </p> <p>Your child will need an operation to take out the stents, usually six to eight weeks after the Mitrofanoff operation.</p> <h3>Urinary catheter</h3> <p>Your child will have a urinary catheter inside the Mitrofanoff. It may or may not be attached to a urine collection bag.</p> <h3>Incision, stitches and gauze</h3> <p>Your child's incision will be closed with stitches. The incision is the place where the surgeon cuts through the skin to operate. The stitches will dissolve about 10 days after the operation. </p> <p>The incision and the stitches will be covered with white gauze. The nurse will change the gauze every day.</p> <h3>Penrose drain</h3> <p>A drain called a Penrose drain may be placed in your child's belly, close to the incision. It takes away the extra liquids that may collect during the operation. This drain looks a lot like a thick elastic band. It will be stitched in place and covered with a piece of gauze. </p> <p>We will take out this drain before your child goes home.</p> <h2>Managing your child's pain</h2> <p>There are several ways to control pain that work well. Which way we use will depend on your child's age and needs.</p> <ul> <li>Your child may get medicine for pain through the IV. </li> <li>Your child may have an epidural catheter. An epidural catheter is a small plastic tube that an anesthesiologist puts into a space in the spine. (The anesthesiologist is the doctor who gives sleep medicine to take away the pain.) The catheter is put in in the operating room. This catheter lets your child have medicine for pain all the time. The epidural catheter works well because it numbs the body below the incision. </li> <li>Once your child feels better, they can swallow their pain medicine. </li></ul> <h2>The cause and treatment of bladder spasms</h2> <p>Catheters and stents may bother the bladder and cause cramps, called bladder spasms. Sometimes bladder spasms can hurt a lot. If your child has painful bladder spasms, they will be given a medicine called a B&O suppository. This medicine relaxes the bladder and reduces the pain. </p> <h3>Symptoms of bladder spasms</h3> <p>Signs that your child is having bladder spasms may include:</p> <ul> <li>pain that comes on quickly and then stops </li> <li>an itchy bottom </li> <li>the need to urinate or have a bowel movement (poo) often </li> <li>your child holding or rubbing their genitals (private parts) more than usual </li> <li>urine leaking around the catheter </li> <li>drawing the knees up to the chest, especially in babies and toddlers </li> </ul> <p>The nurse will check your child's pain control regularly. But you know your child best. The nurse will want to know if you think your child's pain is being controlled well. If you feel your child is in pain, tell the nurse. </p> <h2>Getting active again</h2> <p>Right after the operation, your child will have to stay in bed all day and all night. Your child may not be allowed to sit up for one or two days. While your child is lying in bed, they should try to do these things: </p> <ul> <li>take deep breaths and cough </li> <li>exercise their legs </li> <li>roll from side to side </li> </ul> <p>The nurse will help.</p> <p>The doctor will decide when your child is ready to get out of bed. Your child will have to become active slowly. Your child can start by sitting in a chair. Then they can slowly start to walk when they are ready. </p> <h2>Eating and drinking after the operation</h2> <p>Your child's bowel needs to rest after the operation. So your child will not be able to eat or drink for a while. When they begin to feel grumbling in the stomach and passes gas, the doctor will take out the nasogastric tube. </p> <p>Your child will be allowed only clear liquids at first. They can eat normal food after a few days.</p> <p>Your child must drink as much liquid as possible. This will help the catheters drain well.</p><h2>Preparing for the operation</h2> <p>Before any operation, patients often have to do specific things to prepare. Staff at the hospital will tell you what you need to do before the operation. They will give you a brochure or pamphlet to read. If you do not get this information, ask. If you have more questions after reading the pamphlet, ask. </p> <p>Because the surgeon will cut out your child's appendix, it is important to make sure that your child's bowel is as clean as it can be before the operation. Getting the bowel as clean as possible means restricting what your child eats and having enemas. </p> <h3>Eating and drinking</h3> <p>For two to three days before the operation, your child should only have clear fluids to drink. Clear fluids are liquids you can see through, like water, apple juice, ginger ale, Sprite, Jello and freezies. Your child cannot have anything else to eat or drink. </p> <p>Write the date of your child's operation here:</p> <p>Write the date your child must start having only clear fluids here:</p> <h3>Enemas</h3> <p>Your child will need to have several enemas. An enema means that a small tube is put into your child's anus and water is flushed inside. Then, your child will go to the bathroom and expel the water and feces (poo) from the bowel. Usually, enemas are a bit uncomfortable but they do not hurt. </p><h2>At SickKids</h2> <h3>Supporting your child</h3> <p>When preparing your child for an operation, the urology team recommends that whenever possible, your child and family members attend the Pre-Admission Program offered at SickKids. For more information call 416-813-6150 or visit the website at www.sickkids.ca </p> <p>A Child Life Specialist can also help to prepare and support your child if they are anxious about the operation.</p><h2>Useful websites</h2> <p><a href="http://www.sickkids.ca/" target="_blank">www.sickkids.ca</a> </p> <p><a href="/">www.aboutkidshealth.ca</a> </p> <p><a href="http://www.cua.org/" target="_blank">www.cua.org</a> </p>https://assets.aboutkidshealth.ca/akhassets/Mitrofanoff_MED_ILL_EN.jpgMitrofanoff

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