There have been attempts to replicate the Xiao procedure in the United States. The first trial involved two traumatic SCI patients—a complete T6 and T11, respectively—causing neurogenic detrusor overactivity with DESD. Prior to the nerve rerouting surgery, they were being managed by clean intermittent catheterization and anticholinergics. An intradural anastomosis was unilaterally made between the VR of L5 to S3. Six months postoperatively, detrusor contractions were elicited via cutaneous L5 stimulation in both patients, as was a significant decrease in detrusor overactivity. By the 15-month follow-up, both patients were completely off anticholinergics and clean intermittent catheterization. Cystometrogram studies show that L5 stimulation generates a detrusor contraction of 59 cm H20 and a maximum flow rate of 8 mL/s with no DESD. Voided volume was 150 mL, and postvoid residual was 200 mL. No significant complications were noted in this small cohort [19].

A larger study was carried out in a group of nine spina bifida patients (mean age, 8 years [range, 6╟37 years]).