Renal Function and Quality of Life after the Mitrofanoff Procedure.

INTRODUCTION: Bladder dysfunction in children can result in recurrent urinary tract infections (UTIs), incontinence, and progressive renal impairment. The Mitrofanoff procedure (MP) facilitates clean intermittent catheterization (CIC), promoting effective bladder emptying and reducing the risk of renal deterioration. However, data on long-term outcomes of this procedure remain limited in developing countries. This study was undertaken to address this gap and evaluate renal function and quality of life (QOL) following the MP in this population. AIMS: To describe mid to long term renal function and QOL in children after MP and to analyze risk factors that influence these outcomes. METHODOLOGY: A retrospective longitudinal cohort study was conducted on children who underwent the MP between 2008 and 2023 with at least 6 months of follow-up. Renal function (estimated glomerular filtration rate, chronic kidney disease staging), QOL (Pediatric Incontinence Questionnaire scores), continence status, and CIC compliance were evaluated. Factors influencing renal outcomes were analyzed. RESULTS: Sixty-two children were included (mean age 7.5 years; mean follow-up 3.2 years). Renal function remained stable or improved in 48 (77.4%) and deteriorated in 14. Recurrent UTIs resolved in 35 of 45 affected children. CIC compliance was observed in 48 (77.4%) and was strongly associated with better renal outcomes. Social continence was achieved in 60 children, and QOL improved in 58 (93.5%). CONCLUSION: The MP, combined with consistent CIC, effectively preserves renal function and enhances QOL in children with bladder dysfunction. Noncompliance with CIC and recurrent UTIs remain key risk factors for renal deterioration.