Paralysed Bladder After Cauda Equina Syndrome
Cauda equina syndrome can 'paralyse' the bladder, where sensation is lost and the muscles are unable to contract. This will lead to the retention of urine.
What is cauda equina syndrome?
Cauda equina syndrome is when neurological dysfunction occurs due to the compression of the cauda equina nerves, which are located at the bottom of the spine.
The nerves are very delicate, so any sort of compression will cause them damage. Compression is often due to a slipped disc, although it can occur in other ways such as the growth of a spinal tumour or arthritis in the spine.
The compression of the cauda equina nerves will lead to a number of neurological symptoms. Only when these symptoms appear is a patient said to have cauda equina syndrome.
Why does it affect the bladder?
The cauda equina nerves have various functions, one of which is to provide sensation and movement to the bladder.
Bladder sensation enables us to know when the bladder is full and we need to urinate. Sensation extends down through the urethra, so we can feel the passage of urine leaving our bodies. Bladder movement means that we can contract our bladders to actually expel urine. Without this function we cannot empty our bladders.
When the cauda equina nerves are damaged due to compression, they will not work properly and these functions will be reduced.
What symptoms will bladder dysfunction cause?
The individual will begin to notice that he/she has developed poor flow, where urine comes out very slowly. It may be necessary to push on the bladder, while women might find they need to stand up. The sensation will also feel strange and it may feel numb when wiping.
These symptoms usually worsen the longer the compression continues. The next stage is for sensation to be lost altogether, where the individual does not know whether or not the bladder is full. It will also be hard to urinate voluntarily.
Consequently the bladder will fill up until it reaches capacity, after which it will simply overflow, where urine leaks out of the urethra without the patient having any executive control. However, due to the loss of sensation the individual does not actually realise he/she has been incontinence until the wet clothes/bedsheets are noticed.
It is this second stage – where urine is retained in the bladder (called urinary retention) – that signifies the bladder has become paralysed.
Is bladder paralysis permanent?
Once the bladder has become paralysed, it indicates that the nerves have become irreparably injured and the patient's symptoms will be permanent. The only way to avoid permanent bladder paralysis is to operate on the patient while there is still a degree of bladder control. If decompression surgery is achieved in time, the patient can make a recovery.
If your treatment was delayed, leaving you with permanent neurological dysfunction, please get in touch with us to see if you have been the victim of medical negligence.
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