Do You Have To Strain To Urinate?

If you are having to strain to urinate, you need to check whether you have a rare neurological condition called cauda equina syndrome. In this article we explore the symptoms of cauda equina syndrome, helping you understand if require emergency medical intervention.

Symptoms of cauda equina syndrome

In a recent clinical review in the British Medical Journal, Lavy et al list the features of cauda equina syndrome as:

• Dysfunction of bowel, bladder or sexual function
• Sensory changes in saddle or perineal area

Other possible symptoms include:

• Back pain (with or without sciatic type pain)
• Sensory changes or numbness in the lower limbs
• Lower limb weakness
• Reduction or loss of reflexes in the lower limbs
• Unilateral or bilateral symptoms

The cardinal features are perianal sensory loss, sphincter disturbance and urinary retention. These symptoms may develop in one of three ways:

1. Acutely and suddenly
2. After a long history of back pain
3. Slowly with a progressive worsening of numbness and urinary symptoms

Cauda equina syndrome and urinary difficulties

Out of all the symptoms of cauda equina syndrome, one of the most notable is urinary dysfunction. This is because humans pass urine on a regular basis, and any degree of urinary difficulties will become readily apparent.

Having to strain to urinate is a common sign of cauda equina syndrome, as is female patients having to stand to urinate. Other complaints might include increased frequency but with the inability to fully empty the bladder, along with decreased sensation in the urethra and a poor stream.

Have you got these symptoms?

If you have developed urinary dysfunction and you are also displaying some or all of the other symptoms of cauda equina syndrome, you must seek emergency medical attention. Cauda equina syndrome must be treated immediately if long-term complications are to be avoided.

When you seek medical help, you should undergo a neurological examination as this will help medical practitioners establish the extent of your neurological deficit. You should also have blood and urine tests to check you are not suffering a more minor illness such as a urinary tract infection.

If your history of symptoms and the examination tally with cauda equina syndrome, you should be sent for an emergency MRI scan. This will reveal whether or not you cauda equina nerves are being compressed.

Medical failings

If medical practitioners fail to recognise the symptoms of cauda equina syndrome and therefore fail to refer a patient for an emergency MRI scan, there will be a substandard level of medical care. If this has happened to you and it has caused you to suffer long-term complications, you will be able to claim compensation. Contact us today to find out more.

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