Mitrofanoff cystolitholapaxy: an innovative method of stone clearance in a hostile abdomen with an inaccessible urethra.

Patients with urinary tract diversion are at increased risk of cystolithiasis. Management of intravesical calculi poses challenges for the urologist even if non interventional methods of stone clearance are employed. Endourological approaches remain the mainstay of treatment in the management of the patient with an anatomically unique bladder but access can potentially traumatize a reconstructed tract with a conduit mechanism. Therefore achieving complete stone removal while minimizing damage to a reconstructed bladder is difficult in this patient subgroup and the management of neuropathic patients has led to the development of innovative procedures that permit minimally invasive access. Consequently, specific to the neuropathic patient with complex, long term bladder management issues any technique which (a) reduces complications and is (b) reproducible with minimal effects on aberrant anatomy is desirable.