Endoscopic Examination of Mitrofanoff Channel Findings and Subsequent Surgical Change of Management—Observations From a 2‐Year Patient Cohort

INTRODUCTION: A Mitrofanoff channel is a continent catheterisable channel, most commonly constructed from the appendix or small bowel (Monti channel) to provide an alternative to the urethra for intermittent catheterization. It is imperative for patients to be counselled on the risks of channel complications, including stomal stenosis, recurrent urinary tract infections (rUTI), and, less commonly, incontinence. Endoscopy of the Mitrofanoff (Mitrofanoscopy), is a diagnostic tool employed in these scenarios to visualize the channel and bladder. Herein, we aim to characterize the findings of Mitrofanoscopy and establish whether this leads to a change in surgical management. METHODS: A single centre, retrospective review of diagnostic Mitrofanoscopy performed to assess for channel complications between January 2023 and January 2025. RESULTS: Of 140 procedures, 83 diagnostic procedures were analyzed. The overall diagnostic yield (defined as the presence of one or more positive findings) was 55.4%. This was highest when performed for difficulty with catheterizing the channel (74.3%), and lowest for channel leak (22.2%). 34.9% (N = 29) of patients required a change in surgical management, including channel dilatation (32.5%), superficial revision (13.8%), complete revision of the Mitrofanoff channel (27.6%), fistula repair (3.4%) and/or repeat Mitrofanoscopy for lithotripsy (3.4%), biopsy, bladder washout or surveillance of benign lesions (13.8%). CONCLUSION: The findings can be used to better inform patients during the consenting process by providing more accurate expectations regarding diagnostic yield and downstream management. Mitrofanoscopy is most useful when investigating patients having difficulty catheterizing and may have limited value in those with isolated channel leak.