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Bladder function is something we all too frequently take for granted. In cauda equina syndrome, the loss of function can signal other devastating life-long symptoms.
Long-term urinary problems are a key feature of cauda equina syndrome. When surgery is carried out too late to bring about recovery, the patient may be left unable to sense when they need to wee and unable to control their loss of urine. They may, effectively, become incontinent of urine.
If their symptoms have deteriorated to this point, it is likely that the patient will also be struggling with control of their bowels, losing sexual sensation, and experiencing pain and weakness in one if not both legs.
As can be seen from the above, the long-term impact of cauda equina syndrome can be thoroughly miserable, affecting the victim’s ability to work, socialise or function and live independently.
Urinary symptoms are also regarded as highly significant in identifying the best moment for surgery.
The patient’s urinary experience is often taken as a benchmark for the extent of compression of the nerves and the consequent likelihood that decompression surgery might halt deterioration of or, possibly, improve function.
When a patient visits their GP or A&E with altered experience when urinating but still retaining some sensation and control, this is considered to be the most vital moment at which surgery should take place.
Prior to these symptoms, a patient may not have been sent for an MRI and so it may not be clear that the cauda equina nerves are under pressure. On the other hand, if these symptoms have deteriorated and the patient has completely lost urinary sensation and control, then it may be too late for surgery to make much difference.
Therefore, this is the most important moment for a referral for an MRI scan and the confirmation or exclusion of compressed nerves. This will, if necessary, prompt emergency surgery for decompression.
If a patient visits their GP with lower back and leg pain, they should be certain to mention if they are also starting to experience any alteration in urination such as difficulty emptying the bladder or poor flow.
Equally, if a patient visits the GP with symptoms only in the back and legs, it is vital that they are warned by the GP of the red flag urinary symptoms of cauda equina syndrome and the need to attend A&E as an emergency should those symptoms develop.
If you are suffering the long-term impact of cauda equina syndrome due to a failure to refer you for an emergency MRI whilst you still had urinary control, you may be entitled to make a claim for compensation.
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