Our Summary

This study aimed to investigate the effectiveness of a procedure called the Xiao procedure on children with bladder dysfunction due to spinal cord conditions. Children were divided into two groups for the study - one group only had their spinal cords untethered, while the other group had this procedure as well as the Xiao procedure. The study found that the Xiao procedure did not result in children being able to voluntarily urinate or control their bladder, but those who had undergone the procedure did show improvements in bladder capacity and overall quality of life compared to those who only had their spinal cords untethered. The study concludes that the improvements could be due to a part of the Xiao procedure, rather than the procedure itself. The researchers recommend that further studies be done on animals before more trials on humans are carried out.

FAQs

  1. What is the Xiao procedure and how is it used in treatment of bladder dysfunction in children with spinal cord conditions?
  2. Did the study find that the Xiao procedure helped children to voluntarily urinate or control their bladder?
  3. What improvements were observed in children who underwent the Xiao procedure compared to those who only had their spinal cords untethered?

Doctor’s Tip

A doctor might advise a patient considering detethering surgery to discuss the potential benefits and risks of additional procedures, such as the Xiao procedure, with their healthcare provider. It is important to understand that while the Xiao procedure may not result in immediate improvements in bladder function, it could still have a positive impact on overall quality of life. Further research is needed to fully understand the potential benefits of additional procedures in conjunction with detethering surgery.

Suitable For

Patients who are typically recommended detethering surgery are those with spinal cord conditions such as tethered cord syndrome, spinal cord tumors, spina bifida, or other spinal cord abnormalities that are causing symptoms such as bladder dysfunction, leg weakness, pain, or changes in sensation. Detethering surgery is often recommended when the spinal cord becomes tethered or stuck to surrounding tissues, causing compression and dysfunction. Patients who are experiencing symptoms related to spinal cord tethering may benefit from detethering surgery to relieve pressure on the spinal cord and improve function.

Timeline

  • Before Detethering Surgery:
  1. Patient presents with symptoms such as back pain, leg weakness, bladder dysfunction, and gait disturbances.
  2. Diagnostic tests such as MRI or CT scans are performed to confirm the presence of a tethered spinal cord.
  3. Patient undergoes pre-operative evaluations and consultations with the neurosurgeon.
  4. Surgery is scheduled, and the patient is informed of the risks and benefits of the procedure.
  • After Detethering Surgery:
  1. Patient is monitored closely in the recovery room for any immediate post-operative complications.
  2. Patient may experience pain and discomfort at the surgical site, which is managed with pain medications.
  3. Physical therapy and rehabilitation may be recommended to help the patient regain strength and mobility.
  4. Follow-up appointments are scheduled with the neurosurgeon to monitor the patient’s progress and address any concerns.
  5. Over time, the patient may experience improvements in symptoms such as bladder dysfunction and gait disturbances.
  6. Patient’s quality of life may improve as a result of the surgery.

What to Ask Your Doctor

  1. What is detethering surgery and why is it recommended for me?

  2. What are the potential risks and complications associated with detethering surgery?

  3. What is the success rate of detethering surgery in improving bladder dysfunction in patients with spinal cord conditions?

  4. What is the Xiao procedure and how does it differ from traditional detethering surgery?

  5. What are the potential benefits of incorporating the Xiao procedure into my detethering surgery?

  6. Are there any alternative treatments or therapies that may be effective in treating my bladder dysfunction?

  7. How long is the recovery process after detethering surgery and the Xiao procedure?

  8. Will I need any additional follow-up appointments or treatments after the surgery?

  9. Are there any lifestyle changes or modifications I should make to improve the effectiveness of the surgery?

  10. Are there any ongoing research studies or clinical trials related to detethering surgery and bladder dysfunction that I should be aware of?

Reference

Authors: Tuite GF, Homsy Y, Polsky EG, Reilly MA, Carey CM, Winesett SP, Rodriguez LF, Storrs BB, Gaskill SJ, Tetreault LL, Martinez DG, Amankwah EK. Journal: J Urol. 2016 Dec;196(6):1735-1740. doi: 10.1016/j.juro.2016.05.111. Epub 2016 Jun 8. PMID: 27288694