ABSTRACT
Cauda equina and conus medullaris are injuries that may result in profound functional compromise of both the urinary bladder and the pelvic floor musculature. Conus medullaris injuries are similar in many respects in that they also result in significant lower extremity and lower urinary tract dysfunction. Disorders affecting the cauda equina are characterized by weakness and sensory loss in the lower limbs, buttocks and perineum, usually with functional abnormalities of bladder, bowel, and sexual function. A unilateral or mild sensory deficit portends a more favorable prognosis as normal bladder function predisposes an intact visceral reflex arc of the sacral nerve roots. Assessment of the patient’s postvoid residual volume should be made by catheterization or an ultrasound bladder scanning device. Urologic management of patient with cauda equina syndrome should be guided by the patient’s symptoms and in accordance with sound urologic principles.
