Creation of continence mechanisms (Mitrofanoff) without appendix: The Monti and spiral Monti procedures

This is a review of the technique to create a continent catheterizable stoma using the Yang-Monti principle of a transversely tubularized segment of bowel. Pediatric urologists have widely used this technique for years, especially when the appendix is either not available or suitable for use. It provides the surgeon with a reliable, predictable, and durable method for creating a continent catheterizable channel. The indications for its use, principles of construction, and outcomes in a large population of children are described.