Will My Bladder Symptoms Improve After Cauda Equina Surgery?
If a patient is going to recover function after decompression surgery for cauda equina syndrome, it is most likely to happen in the first two years. Sometimes a patient will continue to recover for up to four or five years after surgery, although this is rare.
Urinary frequency and urgency after CES
Cauda equina syndrome can affect the bladder, causing problems such as reduced sensation, urinary retention, urinary incontinence, increased frequency and increased urgency.
Patients with ongoing bladder dysfunction are at risk of developing recurrent urinary tract infections because of impaired bladder emptying. Patients with high pressure bladders are also at risk of developing kidney failure because there will be a reflux of urine back up to the kidneys. However, renal scarring (damage) is uncommon when the patient has a low pressure bladder.
Treating bladder frequency and urgency
As mentioned above, if a period of two years has passed since surgery, these symptoms are likely to be permanent. This will of course be very unpleasant, but it may be possible to control the patient's symptoms with medical intervention.
In terms of bladder urgency, a trial of anticholinergic medication might help. Nevertheless, this will not necessarily cure the problem. One study found that after 12 months, 14-35% of patients remained on the same treatment. Thus a patient may respond to the medication, but it may not be a long-term solution.
Patients who fail to respond to anticholinergic medication can be managed by intravesical (bladder) Botox injections. Botox injections are carried out via cystoscope, which is when a telescope is inserted through the urethra and into the bladder. This can be done under local, spinal or general anaesthetic as a day case procedure. Injections are made at multiple sites in the bladder for every six to 12 months.
Bladder Botox injections are able to produce an impressive reduction in frequency and urgency symptoms. Approximate 70-80% of patients will benefit from bladder Botox injections in terms of the reduction of symptoms.
The main negative side-effect of Botox injections is urinary retention for several months after each treatment cycle. This will necessitate intermittent self-catheterisation.
Have you been left with permanent symptoms?
If you have been left with permanent cauda equina symptoms because your medical treatment was delayed, you could be the victim of medical negligence. This would entitle you to pursue a claim for compensation.
Please get in touch with us to find out if you are able to make a cauda equina claim.
Expert legal advice
To find out if you can claim for cauda equina syndrome, please contact us at Glynns Solicitors. We specialise in cauda equina claims and can provide professional legal advice.
Please contact us if you would like to discuss your situation. Please call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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