Cauda Equina Syndrome (CES)

Cauda Equina Syndrome (CES) is compression of the spinal nerves at the tail end of the spinal cord. These nerves are responsible for controlling bladder and bowel function, as well as sensation in and around your genitals, back passage, bladder and bowel.

When these nerves become compressed it can affect their function, and urgent attention is needed. It is rare, occurring in one to three in 100,000 people.

If you have suddenly developed or noticed a rapid change in 2 more of the following symptoms within the past week attend the Emergency Department immediately.

  • Loss of feeling or pins and needles between your inner thighs or genitals
  • Numbness in or around your back passage or buttocks
  • Altered feeling when using toilet paper to wipe yourself
  • Increasing difficulty when you try to urinate
  • Increasing difficulty when you try to stop or control your flow of urine
  • Loss of sensation when you pass urine
  • Unaware of leaking urine or recent need to use pads
  • Not knowing when your bladder is either full or empty
  • Inability to stop bowel movement or being unaware of leaking
  • Loss of sensation when you pass a bowel motion
  • Change in ability to achieve an erection or ejaculate
  • Loss of sensation in genitals during sexual intercourse

Acknowledgement to Dr Susan Greenhalgh, Chris Mercer, Laura Finucane and James Selfe

With any combination of these symptoms, seek help immediately via A&E.

Cauda Equina Syndrome Warning Card

The Cauda Equina Syndrome Warning Card has been developed by Bolton NHS Foundation Trust and can serve as a reminder of what to do in case you develop any symptoms of CES. It is recommended to print a copy and keep it in a safe place, in case your symptoms deteriorate.