1. Bladder Autoaugmentation and Mitrofanoff Appendicovesicostomy on a patient with Caudal Regression Syndrome: A Case Report
Alonzo, Ivan; Amaro, Alejandra; Amolenda, Patricia; Andal, Charlotte; Ang, Jessy; Ang, Joanne; Ang, Kevin; Aningalan, Arvin; Antonio, Abigaille; Aramburo, Jan; Arcilla, Martin; Argana, Desiree
Consultant-in-charge: Dr. Bolong
Resident-in-charge: Dr. Arcinas
University of Santo Tomas
Department of Surgery
February 9, 2011

2. Caudal Regression Syndrome
Occurs in one in 25,000 live births
Characterized by a series of congenital anomalies, including complete or partial agenesis of the sacrum and lumbar vertebrae associated with pelvic deformity
Commonly seen are femoral hypoplasia, clubbed feet, and flexion contractures of the lower extremities
CRS is also associated with presence of two umbilical arteries, non-lethal renal anomalies, non-fused lower limbs, abdominal wall defects, and abnormalities of tracheoesophageal tree, neural tube and heart
Patients with CRS lack motor function below the level of the remaining normal spine but sensation tends to be present at much more caudal levels

3. Caudal Regression Syndrome
The cause is little understood
CRS is strongly associated with maternal diabetes mellitus. Infants of diabetic mothers have two to three times the average incidence of congenital anomalies

4. Mitrofanoff Appendicovesicostomy
Provides an alternative means to access the bladder
It uses the appendix to create a conduit to the bladder, through which patients with a sensitive, absent, or traumatized urethra can perform clean intermittent catheterization easily
It is typically performed when there is blockage of the urethral canal or when there is need for frequent catheterization as in neurogenic bladder

5. Mitrofanoff Appendicovesicostomy
The procedure involves separating the appendix from the cecum
One end of the appendix is connected to the urinary bladder and the other end is connected to skin forming a stoma
An incision is made in the umbilicus to serve as the canal for the catheter