Cauda equina syndrome will progress from incomplete to complete. But how long before the condition becomes complete?
CES incomplete and CES complete
When a patient first gets cauda equina syndrome, their condition is incomplete. You can tell it is incomplete because there will be a degree of bladder control. Most notably, the patient will know when they need to urinate and will be able to pass some urine, although the flow may be poor and sensation altered.
This urinary dysfunction is happening because the nerves at the base of the spine are being compressed and damaged. As the compression continues, the nerves will become increasingly damaged. Accordingly, the patient’s symptoms will get worse until finally their condition is complete.
You can tell when cauda equina syndrome is complete because there will be a total loss of bladder control. The patient will not be aware of the need to urinate. Consequently urine will be retained in the bladder – this is called urinary retention. So much urine will collect in the bladder that it will overflow, resulting in an episode of incontinence. Because of the loss of sensation, the patient may only realise there has been an accident when they notice their sheets or clothes are wet.
How much time until CES is complete?
There is no set time between incomplete and complete cauda equina syndrome. The symptoms associated with incomplete cauda equina syndrome can last for a day before the patient develops urinary retention. However, incomplete cauda equina syndrome can also last for months.
It is worth noting that the longer a patient has incomplete cauda equina syndrome, the less likely it is that bladder function will return to normal.
Fast treatment of cauda equina syndrome
Therefore even if a patient does not have acute cauda equina syndrome (where the symptoms progress very quickly) treatment must be given as a matter of urgency. Certainly treatment is needed before the condition becomes complete, or the eventual outcome will be poor.
Doctors must recognise the symptoms that characterise incomplete cauda equina syndrome. These are a pre-cursor to the more sinister symptoms of complete cauda equina syndrome. A good standard of practice would be to examine a patient with symptoms of incomplete CES and send them for an emergency/urgent MRI scan. This will confirm whether a patient has nerve compression.
Failure to act upon symptoms of incomplete CES
If medical practitioners did not diagnose and treat your cauda equina syndrome while the condition was incomplete, you could be the victim of medical negligence. You could be entitled to claim compensation for the injuries you suffered as a result of progressing to complete CES.