Malone Procedure Combined with Mitrofanoff Using a Divided Appendix and Vesical Enlargement Description of the Surgical Technique and Case Report

Surgical treatment for neurogenic bladder has evolved notably. A great number of patients with neurogenic bladder also present fecal incontinence and treatment for these patients is discouraging. With the induction and use of the Malone procedure through appendicostomy, the practitioner may offer the confection of a stoma for cecal catheterization, allowing easy access for daily enemas. The objective of this report is to present one surgical technique, where the cecal appendix was divided on the proximal portion created a stoma for antegrade enema (Malone principle) and the distal portion created a stoma for urinary catheterization in an augmented bladder with an intestinal segment (Mitroffanoff principle).