Catheter Tug When Diagnosing Cauda Equina Syndrome

If a patient is unable to feel a catheter tug, it indicates a neurogenic bladder, where the bladder does not function properly due to nerve damage.

A neurogenic bladder is a red flag symptom of cauda equina syndrome, a condition which must be treated immediately.

Catheter tug test

Cauda equina syndrome will lead to urinary problems. Specifically, it will be difficult to fully empty the bladder of urine and the patient may need to strain or push on their abdomen to void. There may also be a loss of sensation in the bladder and the urethra, making it hard to know when to urinate.

If a patient presents to hospital complaining of urinary dysfunction, he/she may be fitted with a catheter. A catheter is a small flexible tube that is inserted into the bladder. The urine flows out of the tube and into a drainage bag.

During the diagnosis process, medical practitioners should pull gently on the catheter tube. A patient should be able to feel this. However, if the patient cannot feel the catheter tug, it shows that he/she has a neurogenic bladder.

A neurogenic bladder is when the bladder loses function and sensation because of neurological (nerve damage). It can be caused in a number of ways, one of which is cauda equina syndrome.

Cather tug test when diagnosing cauda equina syndrome

If a patient cannot feel a catheter tug test, medical practitioners should begin to investigate why there is a neurogenic bladder. The first step should be to note whether there are any other symptoms present.

Cauda equina syndrome is associated with a constellation of symptoms. Along with urinary dysfunction there will also be chronic back pain, reduced/loss of sensation in the perineum, anus and buttocks, and poor rectal tone.

An examination may be needed in order to verify the presence of these symptoms. For example, a digital rectal examination will confirm a lack of rectal tone.

If a patient is displaying these symptoms and cannot feel a catheter tug, cauda equina syndrome should be strongly suspected. A patient should be send for an urgent MRI scan to confirm if this diagnosis is correct.

Failure to diagnose cauda equina syndrome

If medical practitioners fail to spot the symptoms of cauda equina syndrome, thereby delaying the diagnosis and treatment of the condition, there may be a case of medical negligence. Please contact us to find out more.

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