{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:24:51Z","timestamp":1775129091023,"version":"3.50.1"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:p>An intradural somatic-to-autonomic anastomosis, or Xiao procedure, has been described to create a \u201cskin-CNS-bladder\u201d reflex that improves bladder and bowel function in patients with neurogenic bladder and bowel dysfunction. The authors present their experience with a 10-year-old boy with chronic neurogenic bladder and bowel dysfunction related to spinal cord injury who underwent the Xiao procedure. After undergoing a left L-5 ventral root to left S2\u20133 intradural anastomosis, the patient reported that his bladder and bowel dysfunction improved between 6 and 12 months. Two years after the procedure, however, he reported that there was no change in his bladder or bowel dysfunction as compared with his condition prior to the procedure. Frequent, systematic multidisciplinary evaluations produced conflicting data.<\/jats:p>\n<jats:p>Electrophysiological and histological evaluation of the previously performed anastomosis during surgical reexploration 3 years after the Xiao procedure revealed that the anastomosis was in anatomical continuity but neuroma formation had prevented reinnervation. Nerve action potentials were not demonstrable across the anastomosis, and stimulation of the nerve above and below the anastomosis created no bladder or perineal contractions.<\/jats:p>\n<jats:p>This is the first clinical report on the outcome of the Xiao procedure in a child with spinal cord injury outside of China. It is impossible to draw broad conclusions about the efficacy of the procedure based on a single patient with no demonstrable benefit. However, future studies should carefully interpret transient improvements in bladder function, urodynamic findings, and the patient's ability to void in response to scratching after the Xiao procedure. The authors' experience with the featured patient, in whom reinnervation could not be demonstrated, suggests that such changes could be related to factors other than the establishment of a skin-CNS-bladder reflex as a result of a somatic-to-autonomic anastomosis.<\/jats:p>","DOI":"10.3171\/2013.4.peds12302","type":"journal-article","created":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T14:09:22Z","timestamp":1368194962000},"page":"80-86","source":"Crossref","is-referenced-by-count":23,"title":["Attempted bladder reinnervation and creation of a scratch reflex for bladder emptying through a somatic-to-autonomic intradural anastomosis"],"prefix":"10.3171","volume":"12","author":[{"given":"Gerald F.","family":"Tuite","sequence":"first","affiliation":[{"name":"Pediatric Neuroscience Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce B.","family":"Storrs","sequence":"additional","affiliation":[{"name":"Pediatric Neuroscience Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves L.","family":"Homsy","sequence":"additional","affiliation":[{"name":"Departments of Urology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah J.","family":"Gaskill","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan G.","family":"Polsky","sequence":"additional","affiliation":[{"name":"Departments of Urology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret A.","family":"Reilly","sequence":"additional","affiliation":[{"name":"Physical Therapy, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"Gonzalez-Gomez","sequence":"additional","affiliation":[{"name":"Pathology and Nephrology, All Children's Hospital, St. Petersburg;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Parrish","family":"Winesett","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis F.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Pediatric Neuroscience Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn M.","family":"Carey","sequence":"additional","affiliation":[{"name":"Pediatric Neuroscience Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon A.","family":"Perlman","sequence":"additional","affiliation":[{"name":"Pathology and Nephrology, All Children's Hospital, St. Petersburg;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Tetreault","sequence":"additional","affiliation":[{"name":"Pediatric Neuroscience Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds12302","series-title":"J Sex Med","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1111\/j.1743-6109.2008.01155.x","article-title":"Scoring correspondence in outcomes related to erectile dysfunction treatment on a 4-point scale (SCORE-4)","volume":"6","author":"Cappelleri","year":"2009"},{"key":"b2-peds12302","series-title":"J Urol","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1016\/S0022-5347(17)36681-8","article-title":"Selective sacral rhizotomy in children with high pressure neurogenic bladders: preliminary results","volume":"148","author":"Franco","year":"1992"},{"key":"b3-peds12302","series-title":"Scand J Surg","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1177\/145749691110000405","article-title":"Neurogenic bladder in children: basic principles, new therapeutic trends","volume":"100","author":"Guys","year":"2011"},{"key":"b4-peds12302","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"452","DOI":"10.3171\/2009.1.SPINE08540","article-title":"Clinical study of reconstructed bladder innervation below the level of spinal cord injury to produce urination by Achilles tendon-to-bladder reflex contractions. 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