Skip to main content

Xiao Procedure for Neurogenic Bladder in Spinal Cord Injury and Spina Bifida

Abstract

The Xiao procedure, which reroutes nerves surgically to establish a somatic–autonomic reflex arc for restoring voluntary bladder and bowel control in patients with spinal cord injury or spina bifida, is reviewed in this article on its history, current status, and how to optimize its efficiency.

This is a preview of subscription content, access via your institution.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance•• Of major importance

  1. Woolsey RM, Young RR. The clinical diagnosis of disorders of the spinal cord. Neurol Clin. 1991;9:573–83.

    PubMed  CAS  Google Scholar 

  2. Wheeler Jr. JS, Walter JW. Acute urologic management of the patient with spinal cord injury. In Bodner D. R. (Ed), The Urologic Clinics of North America: Spinal Cord Injury. 1993;20:403–11.

  3. Selzman AA, Elder JS, Mapstone TB. Urologic consequences of myelodysplasia and other congenital abnormalities of the spinal cord. Urol Clin North Am. 1993;20:485–504.

    PubMed  CAS  Google Scholar 

  4. Stone AR. Neurourologic evaluation and urologic management of spinal dysraphism. Neurosurg Clin N Am. 1995;6:269–77.

    PubMed  CAS  Google Scholar 

  5. Xiao CG, Schlossberg SM, Morgan CW, Kodama R. A possible new reflex pathway for micturition after spinal cord injury. J Urol. 1990;143:356A.

    Google Scholar 

  6. Xiao CG, Godec CJ. A possible new reflex pathway for micturition after spinal cord injury. Paraplegia. 1994;32:300–7.

    PubMed  Article  CAS  Google Scholar 

  7. Xiao CG, de Groat WC, Godec CJ, Dai C, Xiao Q. “Skin-CNS-bladder” reflex pathway for micturition after spinal cord injury and its underlying mechanisms. J Urol. 1999;162:936–42.

    PubMed  Article  CAS  Google Scholar 

  8. Xiao CG, Du MX, Dai C, Li B, Nitti VW, de Groat WC. An artificial somatic-central nervous system-autonomic reflex pathway for controllable micturition after spinal cord injury: preliminary results in 15 patients. J Urol. 2003;170:1237–41.

    PubMed  Article  Google Scholar 

  9. Xiao CG, et al. An artificial somatic-autonomic reflex pathway procedure for bladder control in children with spina bifida. J Urol. 2005;173:2112–6.

    PubMed  Article  Google Scholar 

  10. Kelley C, et al. Creation of a somatic-autonomic reflex pathway for treatment of neurogenic bladder in patients with spinal cord injury: preliminary results of the first 2 USA Patients. J Urol. 2005;173:1132A.

    Article  Google Scholar 

  11. Xiao CG: A somatic-autonomic reflex pathway procedure for refunctionization of bladder and bowel in SCI and spina bifida. Lecture on SIU 29th annual meeting, Shanghai, 2009. http://webcasts.prous.com/netadmin/webcast_viewer/Preview.aspx?type=0&lid=10196&pv=2&preview=False&idcl=1.

  12. Lin H, Hou CL, Zhong G, Xie Q, Wang S. Reconstruction of reflex pathways to the atonic bladder after conus medullaris injury: preliminary clinical results. Microsurgery. 2008;28(6):429–35.

    PubMed  Article  Google Scholar 

  13. • Lin H, Hou C, Chen A. Reconstructed bladder innervation above the level of spinal cord injury to produce urination by abdomen-to-bladder reflex contractions. J Neurosurg Spine 2011;14(6):799–802. This article reported an independent third party repeat of the Xiao procedure for neurogenic bladder in SCI patients.

    PubMed  Article  Google Scholar 

  14. http://www.urotoday.com/infections-1165/aua-2010-outcomes-of-intraspinal-nerve-rerouting-to-reestablish-bladder-function-in-spinal-cord-injured-patients-a-single-center-experience-session-highlights-2229825.html.

  15. Peters KM, Girdler B, Turzewski C, Trock G, Feber K, Nantau W, Bush B, Gonzalez J, Kass E, de Benito J, Diokno A. Outcomes of lumbar to sacral nerve rerouting for spina bifida. J Urol. 2010;184(2):702–7. Epub 2010 Jun 19.

    PubMed  Article  Google Scholar 

  16. Kurzrock EA. Editorial comment. J Urol. 2010;184(2):707. discussion 708. Epub 2010 Jun 19.

    PubMed  Article  Google Scholar 

  17. Park JM. Editorial comment. J Urol. 2010;184(2):708. discussion 708. Epub 2010 Jun 19.

    PubMed  Article  Google Scholar 

  18. •• Peters KM et al. Three year clinical outcomes with lumbar to sacral nerve rerouting in spina bifida. J Urol. 2011, 185:1502A. This publication concluded the first clinical trial of the Xiao procedure for spina bifida patients in the United States, with similar successful results as reported from China.

    Article  Google Scholar 

Download references

Acknowledgments

This work was supported partially by grants from the National Key Basic Research Program of China (2003CB515300), the Ministry of Public Health of China (major clinical trial grant), Natural Science Foundation of China (NSFC 39925033), and National Institutes of Health (R01 DK44877 and R01 DK53063).

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Chuan-Guo Xiao.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Xiao, CG. Xiao Procedure for Neurogenic Bladder in Spinal Cord Injury and Spina Bifida. Curr Bladder Dysfunct Rep 7, 83–87 (2012). https://doi.org/10.1007/s11884-012-0130-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11884-012-0130-2

Keywords

  • Neurogenic bladder
  • Spinal cord injury
  • SCI
  • Spina bifida
  • Xiao procedure
  • Urodynamics
  • Bowel control