Achieving independent urination in two months, the Xiao procedure sets a new record

During her short three-month stay in the hospital, a young girl from the Dong ethnic group in Guizhou, named Xiao Chenyi, left a lasting impression on the hospital staff with her innocent and joyful smile.

Backstory: Xiao Chenyi’s birth was a joyous occasion, but fate dealt her a harsh hand. She was born with an anal tumor that prevented her from defecating normally. The tumor also made urination difficult, causing her constant pain and distress, much to her family’s heartache.

The tumor was a ticking time bomb that could take Xiao Chenyi’s life at any moment. At two months old, her family took her to the hospital for an “anal teratoma excision” and “anal plasty.” Just when her family thought she was out of danger, Xiao Chenyi began to suffer from recurrent fevers and abdominal pain. The surgeries had removed almost all of her sacrococcygeal and sacral nerves, making her incontinence issues worse instead of better.

A local hospital diagnosed her with a urinary tract infection. At just two months old, her difficulty urinating had already caused hydronephrosis. To prevent her condition from worsening, the hospital placed a urinary catheter in her. Thus, the life of this two-month-old girl was destined to be intertwined with catheterization.

Seeking Treatment at Xiao Chuan-Guo Hospital

On April 23, 2017, our medical staff processed Xiao Chenyi’s admission. She was not yet six years old, at the most innocent and adorable age. Despite her health issues, she always had a sweet smile on her face. Her grandfather said that over the past five years, the family had visited many hospitals. Some removed her catheter only to replace it with diapers, while others reinserted the catheter, but none could cure her. Their trip to Shenzhen was a quest for a definitive cure, hoping to free their granddaughter from diapers and catheters forever.

Xiao Chenyi was of kindergarten age, but her family feared that being different from other children due to the catheter would make her feel inferior and be bullied, so they hesitated to send her to school. At home, Xiao Chenyi played by herself, but at the hospital, she made many friends. One day she would swap toys with a girl in the next room, and the next day, she would be carried upstairs by the staff after playing with snacks.

Complex Condition, Urgent Surgery

Despite her joyful demeanor, Xiao Chenyi suffered from a serious illness. The doctors recommended immediate surgery upon diagnosing her. The urgency was due to years of catheter use, which had caused right-sided vesicoureteral reflux, neurogenic bladder, urinary tract infection, and chronic renal failure. The most severe diagnosis revealed she had only one functioning right kidney, which was already in chronic renal failure.

Shocked by the severity and complexity of her condition, Professor Xiao Chuan-Guo and his surgical team discussed Xiao Chenyi’s surgery plan on April 25, just three days after her admission. They decided to perform a right-sided ureteral reimplantation and the Xiao procedure.

During the surgery, Professor Xiao first reimplanted the ureter to prevent reflux and save the remaining solitary kidney. Then, he connected the remaining half of the S1 nerve to the S3 nerve stump, which was unprotected due to the absence of the coccyx. The surgery went smoothly, and the energetic Xiao Chenyi quickly recovered.

Successful Surgery, Rapid Recovery

Typically, children with myelomeningocele take about eight months to regain bladder and bowel control after surgery, with the fastest recovery being four months. However, Xiao Chenyi was able to urinate and defecate normally just two months after surgery! Professor Xiao explained that the rapid recovery was due to the short distance the nerves had to regenerate because the distal stump was close to the bladder.

When we saw her again in the hospital, she had already had her catheter removed and could urinate smoothly on her own. From a little girl who had to pin a long catheter to her skirt wherever she went, to a young girl who could go to the bathroom by herself in just two months, Xiao Chenyi’s miraculous transformation is a testament to Professor Xiao Chuan-Guo’s skill.

Today, as Xiao Chenyi was discharged from the hospital, she took the time to take a photo with Professor Xiao in his office. Free from her ailments, she can now happily carry her backpack to school. At an age when memories begin to form, she is healthy and no different from other children, thanks to her family’s early treatment and years of care.