The Xiao procedure treats neurogenic bladder caused by various reasons.

Xiao Chuan-Guo Hospital’s Xiao Procedure effectively addresses a Range of Symptoms in Patients with Spina Bifida / Myelomeningocele

Performing the Xiao procedure on patients with Spina Bifida / Myelomeningocele yields the following results: Connecting a quarter of the lower limb motor nerves with visceral nerves that regulate bladder voiding to establish a new voiding pathway. When the new nerves have grown and developed sufficiently, the brain can independently control urinary and bowel functions.

Addressing Neurogenic Bladder in Spina Bifida via the Xiao Procedure

Every year, 200,000 babies worldwide are born with spina bifida, including 2,758 cases in the U.S. Globally, around 3 million people live with the condition. The Spina Bifida Association estimates that about 70,000 people in the United States have spina bifida[1]. Neurogenic bladder is common in these children, affecting up to 98% with myelomeningocele.

The Xiao procedure utilizes safe and effective nerve anastomosis techniques to address fecal and urinary incontinence in individuals with spina bifida, enabling them to fully reintegrate into normal life.

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The Impact of Spina Bifida on Patients and Families

Impairs cognition and neurology, especially with myelomeningocele, affecting thinking, attention, and learning abilities.
Affects physical growth, leading to early puberty, shorter height, and higher obesity rates.
Requires multiple surgeries like shunt adjustments and orthopedic procedures, posing challenges for patients and families.
Managing bowel and bladder functions and walking can be challenging, impacting daily life.
Social skills are uniquely affected, creating additional challenges.
Achieving typical milestones like independence may be difficult, requiring family support.
Families with young members face lower cohesion levels and parents may experience psychological distress.
Spina bifida requires ongoing, costly treatment, with a lifetime cost of around $791,900 in the US, including caregiving expenses.

Preventing and Treating Spina Bifida with Traditional Methods

Supplementing Folic Acid
Starting folic acid supplementation one month before pregnancy can significantly prevent the birth of babies with spina bifida.

Treatment of Spina Bifida in Babies During Pregnancy

Treating spina bifida, a spinal birth defect, involves prenatal or postnatal surgery. The choice depends on factors like pregnancy stage, spinal bulge location, Chiari II malformation presence, and maternal health. Prenatal surgery requires significant commitment from the mother and her support system. Specialized hospital teams guide families in weighing treatment options and provide support for those choosing to terminate the pregnancy.

It is important to note that there is currently no evidence that prenatal surgery can significantly improve the symptoms of a baby with spina bifida. However, it is a very complex surgery, and high risks are unavoidable. Since our hospital currently offers the Xiao procedure that can completely cure spina bifida after the baby is born, we advise you not to have surgery on the baby before birth.

Long-Term Complications of Spina Bifida/Myelomeningocele

Incontinence

Loss of control over bladder or bowel function.

Tethered Cord Syndrome

Abnormal attachment of the spinal cord within the spinal column.

Neurogenic Bladder

Bladder dysfunction caused by nerve damage.

Urinary Retention

Inability to completely empty the bladder.

Vesicoureteral Reflux

Backward flow of urine from the bladder to the kidneys.

Severe Hydronephrosis

Swelling of the kidneys due to urine accumulation.

Lower Limb Deformity

Abnormality in the structure of the lower limbs.

Traditional Methods of Treating Spina Bifida After Birth

Myelomeningocele Repair Surgery

Directly removing the protruding part of the meninges in the lumbosacral region to prevent cerebrospinal fluid leakage and infection. However, this procedure may inadvertently damage the nerves controlling the bladder and rectum, leading to greater nerve destruction and injury.

Bladder Augmentation Surgery

Only increasing the bladder capacity, resulting in loss of bladder function.

Spinal Cord Detethering Surgery

Only increasing the bladder capacity, resulting in loss of bladder function.

Bladder Diversion Surgery, Indwelling Catheterization, Intermittent Catheterization

The main purpose is to drain residual urine from the bladder to prevent or delay urinary tract infections and kidney swelling. However, they do not fundamentally resolve urinary and bowel dysfunction issues.

The Spina Bifida Program at Xiao Chuan-Guo Hospital

Conus Medullaris Expansion Decompression

Ensuring adequate decompression of the nerve root holes to prevent spinal canal narrowing and nerve root compression.

Spina Bifida, Myelomeningocele Repair

Removing cystic structures, repairing fissures, separating adhered spinal cord or nerve roots, and reintegrating them into the spinal canal without causing damage.

Spinal Cord Detethering Surgery

For patients with tethered spinal cord syndrome, during spinal canal exploration, adhesions are released and the filum terminale is cut to prevent further damage and injury to lower limb function.

Nerve Reconnection Surgery

Connecting one-fourth of the motor nerves of the lower limbs with visceral nerves controlling bladder voiding to create a new voiding pathway. Once the new nerves have grown and developed well, the brain can autonomously control urinary and bowel functions.

Xiao Procedure for Treating Hidden Spina Bifida

Hidden spina bifida （or Spina bifida occulta） usually presents as a flaw in the spinal canal without the spinal contents sticking out, often showing up as an indent on the lower back. Some people start showing symptoms in infancy or early childhood, whereas others might not have symptoms until adulthood. This aligns with a range of secondary pathological changes brought on by spina bifida and the progressive aggravation and ischemic alterations linked with tethered spinal cord syndrome.

No clinical symptoms present.

Continuous observation without treatment is an option.

Experiencing long-term bedwetting, frequent nighttime bedwetting, difficulty passing dry stools, mild leg atrophy, etc.

Treatment methods: 1. Release nerve adhesions causing neural compression within the spinal canal; 2. Patients with severe urinary incontinence may require Xiao Procedure surgery.