Objective The mechanisms of neurogenic bowel dysfunction (NBD) and neurogenic bladder (NB), which are major consequences of spinal cord injury and occasionally degenerative lumbar disease. The following in patients with cauda equina syndrome who underwent posterior decompression surgery was investigated: (1) the preoperative prevalence of NBD and NB, measured using the Constipation Scoring System (CSS) and International Prostate Symptoms Score (IPSS); (2) the degree and timing of postoperative improvement of NBD and NB.
Methods We administered the CSS and IPSS in 93 patients before surgery and at 1, 3, 6, and 12 months postoperatively. We prospectively examined patient characteristics, Japanese Orthopaedic Association (JOA) score, and postoperative improvements in each score.
Results The prevalence of symptomatic defecation and urinary symptoms at admission were 37 patients (38.1%) and 31 patients (33.3%), respectively. Among the symptomatic patients with defecation problems, 12 patients had improved at 1 month, 13 at 3 months, 14 at 6 months, and 13 at 12 months postoperatively. Among the symptomatic patients with urinary problems, 5 patients improved at 1 month, 11 at 3 months, 6 at 6 months, and 10 at 1 year postoperatively. Comparing patients with improved versus unimproved in CSS, the degree of JOA score improvement was a significant prognosis factor (p < 0.05; odds ratio, 1.05).
Conclusion The prevalence of symptomatic defecation and urinary symptoms in patients with cauda equina syndrome was 38.1% and 33.3%, respectively. Decompression surgery improved symptoms in 30%–50%. These effects were first observed 1 month after the operation and persisted up to 1 year.
Citations
Citations to this article as recorded by
Pathophysiology and Evaluation of Urination and Defecation Ryo Kanematsu, Toshiyuki Takahashi, Manabu Minami, Kengo Setta, Junya Hanakita Spinal Surgery.2026; 40(1): 14. CrossRef
Prevalence and Risk of Urinary Dysfunction in Cervical and Lumbar Degenerative Spinal Disease: A Large-Scale Population-Based Study Soo-Bin Lee, Ji-Won Kwon, Seong-Hwan Moon, Kyung-Soo Suk, Hak-Sun Kim, Si-Young Park, Byung Ho Lee Global Spine Journal.2026;[Epub] CrossRef
Analysis of Neurogenic Bowel and Bladder Dysfunction Following Decompression Surgery for Cervical Spondylotic Myelopathy: A Prospective Cohort Study Ryo Kanematsu, Junya Hanakita, Tomoo Inoue, Manabu Minami, Izumi Suda, Sho Nakamura, Manabu Ueno, Toshiyuki Takahashi Global Spine Journal.2025; 15(2): 587. CrossRef
Efficacy and safety of transcutaneous electrical nerve stimulation combined with clean intermittent catheterization for neurogenic bladder dysfunction in patients with cauda equina syndrome Xia Wu, Jinlian Huang, Dexian Wu, Guohui Kang, Kuo Li International Urology and Nephrology.2025; 57(10): 3227. CrossRef
Urinary complaints and voiding function in patients operated for lumbar spinal stenosis Bjørn Hjall, Sigurd Liavaag, Hans Thorvild Thomassen, Tor Brommeland Clinical Neurology and Neurosurgery.2025; 257: 109060. CrossRef
Spinal metastases: modern diagnostics, multimodal approach to treatment, and long-term outcomes Anvar F. Nazarov, Rail A. Karaguzin, Danil I. Khalilov, Nadir B. Akhmerov, Elena N. Volkova, Kamila A. Baiguvatova Russian Journal of Oncology.2025; 31(1): 25. CrossRef
Clinical assessment and management of lumbar spinal stenosis: clinical dilemmas and considerations for surgical referral David B Anderson, David J Beard, Francois Rannou, David J Hunter, Pradeep Suri, Lingxiao Chen, James M Van Gelder The Lancet Rheumatology.2024; 6(10): e727. CrossRef
How to assess the long-term recovery outcomes of patients with cauda equina syndrome before surgery: a retrospective cohort study Qiushi Wang, Guangdong Hou, Mengyuan Wen, Zhongwu Ren, Wei Duan, Xin Lei, Zhou Yao, Shixian Zhao, Bin Ye, Zhipeng Tu, Peipei Huang, Fang Xie, Bo Gao, Xueyu Hu, Zhuojing Luo International Journal of Surgery.2024; 110(7): 4197. CrossRef
A CASE REPORT ON LONG TERM COMPLICATIONS OF CAUDA EQUINA SYNDROME Shone Padinjarethil George, Shiby Sara Shaji, Mohan Varghese INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2023; : 60. CrossRef
Application of rectal balloon ice water stimulation for the rehabilitation of stroke patients with neurogenic bowel dysfunction Di Zhang, Hong Tang, Ting Li, Ping Li, Xiangying Pan, Qin Jia, Lu Wang, Yanjun Zhao NeuroRehabilitation.2023; 53(1): 83. CrossRef
Effect of systemic lidocaine on postoperative quality of recovery, the gastrointestinal function, inflammatory cytokines of lumbar spinal stenosis surgery: a randomized trial Yu Wu, Zhuoming Chen, Caimiao Yao, Houxin Sun, Hongxia Li, Xuyang Du, Jianzheng Cheng, Xiaojian Wan Scientific Reports.2023;[Epub] CrossRef
Technical feasibility of combined uniportal unilateral laminotomy with bilateral decompression and interlaminar lumbar discectomy surgery for cauda equina syndrome due to lower lumbar disc herniation Wu Pang Hung, Rohit Akshay Kavishwar, Hyeun Sung Kim, Brian Zhao Jie Chin North American Spine Society Journal (NASSJ).2023; 16: 100290. CrossRef
First
Prev
