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Urinary Retention in Cauda Equina Syndrome

Urinary Retention in Cauda Equina Syndrome

Cauda equina syndrome can cause urinary retention, where the bladder cannot expel urine properly, meaning it remains inside the bladder.

What is urinary retention?

Urinary retention is when the bladder does not empty completely, so that even after going to the toilet there is a certain amount of urine left inside the bladder. This is a symptom frequently associated with urinary tract infections, urethral obstruction, certain medications and nerve damage.

Why does cauda equina syndrome cause retention?

Urinary retention happens during cauda equina syndrome because of nerve damage. Cauda equina syndrome is when the cauda equina nerves at the base of the spine are compressed and injured.

The cauda equina nerves are responsible for a number of things, including providing sensation/function to the bladder. Therefore if the nerves are harmed, two things will happen:

  • Firstly, the muscles inside the bladder will not receive messages from the nerves telling them to push in order to squeeze out urine. Consequently the patient will start to find it difficult to fully empty their bladder, and will then have to visit the toilet more often. There may also be a poor flow of urine with reduced sensation in the urethra.
  • Secondly, the nerves will not tell the brain that the bladder is full. Without this signal, the bladder will continue to fill with urine until it simply cannot hold anymore. It then 'overflows', making the individual release urine unintentionally.

Complete urinary retention

With cauda equina syndrome, the patient will first start to notice that it is difficult to empty their bladder. As the condition progresses and the nerves becomes increasingly damaged, 'complete' urinary retention will occur, where the patient does not know he/she needs to urinate, and cannot do so voluntarily. This is known as 'complete cauda equina syndrome', or 'cauda equina syndrome with retention'.

Complete cauda equina syndrome is associated with a poor outcome. Therefore it is important the condition is recognised in the early stages, when the patient is suffering symptoms such as incomplete emptying of the bladder and numbness. This is called 'incomplete cauda equina syndrome'.

Failure to spot cauda equina syndrome

If medical practitioners fail to diagnose and treat cauda equina syndrome while it is incomplete, causing the patient to develop complete urinary retention, there could be a case of medical negligence. Contact us at Glynns Solicitors to find out more about claiming compensation for medical negligence.

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