After i developed CES i was interested to learn that it is classified as Complete or Incomplete syndrome. I will try to explain the classification and its criteria as simple as possible.
Cauda Equina Syndrome (CES) comes under two classifications:Complete (CES with true retention CESR) or Incomplete (CESI). The measure of classification relies on the bladder or bowel dysfunction in relation to retaining. CESR (Complete CES) patients have already developed true retention. Due to loss of the visceral neurologic signal to the central nervous system which then leads painless urinary retention, and eventually overflow incontinence.In simple terms the nerves are so damaged to the bladder that it causes the bladder to retain and overflow.
To use myself as an example.... if i do not self catheter i tend to leak. I also do not feel uncomfortable when i have a full bladder and i have no urgency to void or empty. Similarly, either retention or incontinence of the bowel may be experienced For me this presents itself by my not being able to voluntarily poop without assistance (retention) so i need the help of bowel programme in addition, in between i leak slightly so this is where the incontinence presents to me.
CESI (incomplete CES) Patients present with motor and sensory changes, including saddle anesthesia, but have yet to develop full retention or incontinence of either bowel or bladder. Instead, in simple terms there is a need to strain to pee, possibly needing to use abdominal compression to assist in voiding also a loss of urgency may be experienced (a known practice of gently pressing over the bladder area to help empty the bladder, i have tried this also), and alteration of urinary sensorium (in my understanding this means not being totally aware when to void as not having full feeling)
The information that is available on the net in relation to the subject is mostly in technical terms so i have done my best to describe the classifications in an easier to understand translation and used myself as an example to help explain better..
Post by kilg0retr0ut on Sept 6, 2013 7:10:13 GMT -8
I didn't know there were different classes of CES. Lara, all this info is great. Relating it to your own experience is also very helpful. Thanks :kiss: Sorry DJ, had to do it :banana:
Mind boggling that I am 4 1/2 years post op and I never knew this!! It's almost frustrating. It also saddens me a bit that I would be classified as 'CES complete'... With that said classification will never stop me from praying for more recovery and working on it by focusing on being as healthy as I can be.
Hey jenkellam, welcome to the forum! :welcome: It surprises me how little info people with CES are given about their diagnosis! I'm my opinion a class doesn't mean much. Everybody's different and some people might start recovering 10 years post (I know a guy who has)! Focusing on recovery is the best we can do at the moment and we will no doubt see the positive results are time goes on.
I hope the best for your recovery and I hope to see you around the forum!
I should add, it is important to know your class especially if you're filing a lawsuit against your doctors but when it comes to recovery, anything is possible so don't let injury level or class make you think otherwise :tup:
Mind boggling that I am 4 1/2 years post op and I never knew this!! It's almost frustrating. It also saddens me a bit that I would be classified as 'CES complete'... With that said classification will never stop me from praying for more recovery and working on it by focusing on being as healthy as I can be.
Hey jenkellam. :welcome:..dont worry to about the classification at all, i am classed as Complete and its surprising at the progress you can make with determination. Hope is always a good thing to possess
The medical profession like to label everything but in our case it can be helpful to know our classification. We have the right to know and it frustrates me to know that we are not given enough information about our condition. We should be told everything.
I aim to make sure this CES forum provides more information than any other resource on the net.....we need to have clear understanding of our bodies
I think it is important to add that being classified as having Complete Cauda Equina Syndrome does NOT mean you are classified as having a Complete Spinal Cord Injury. You can be classified as having a CompleteCES(CESR) and also have an Incomplete Spinal Cord Injury. Likewise you can be classed as CESR and also have a complete SCI.
The original thread refers only to the criteria for classification of Incomplete or Complete Cauda Equina Syndrome.
Complete and Incomplete Spinal Cord Injury is this:
“Complete” Spinal Cord Injuries refer to any injury that results in the complete loss of function below the point of injury.
“Incomplete” Spinal Cord Injury refers to a spinal cord injury in which some feeling or movement is still evident below the point of injury.
As you can see the classification for Spinal Cord Injury Complete or Incomplete is not the same classification criteria for Cauda Equina Syndrome Complete or Incomplete
Mind boggling that I am 4 1/2 years post op and I never knew this!! It's almost frustrating. It also saddens me a bit that I would be classified as 'CES complete'... With that said classification will never stop me from praying for more recovery and working on it by focusing on being as healthy as I can be.
Thanks Lara ...the information was very helpful... I am a complete CES .... What really worries me is I worked so hard to gain the strength back in my legs and still continue to cycle to keep fit and keep my strength.. will my strength regress if I ever stop
Thanks Lara ...the information was very helpful... I am a complete CES .... What really worries me is I worked so hard to gain the strength back in my legs and still continue to cycle to keep fit and keep my strength.. will my strength regress if I ever stop
benson..i first want to say that im impressed by your determination and hard work...it has paid off for you!
I can only use myself as an example and you conclude from that if you can relate. A lot depends on the muscle power that you have to your lower extremities...what nerves are still damaged etc but i will try to give you some insight based on my experience and thoughts on this.
I have damaged nerves to approximately 70% of my muscles from below my injury level..basically from my glutes and below. The muscles that they supply either have no power to them or very little power. This affects some movements and upright mobility. I have worked very hard to build up the muscles which have normal power to them and then improve the strength in the weaker ones.
I go to the gym 6 days a week for one hour to keep building up what i can and i push my walking until it comes to the point where i am uncomfortable and then i rest.
The more i work at it the stronger i get, if i take a break and dont go for a couple of weeks i can feel the weakness returning. I do feel that if i did not work as hard as i do..i would spend more time in my chair. After saying that...i have a limit still on my walking, i feel this is because the muscles that support the weaker ones become fatigued naturally....can i make them even more stronger? Im not sure....this one is working progress for me right now so i may have the answer in another 6 months. I also permanently diet to keep my weight down...(im a curvy girl) and i know this is helping.
For you, i think if you were to stop the exercise then you may experience some weakness return but thats if you have nerve damage still remaining in your lower extremities.
If your strength has returned because nerves have re generated then you should not see a significant difference.
Everyone gets stronger if they build their muscles up and fitness and if they stop then they will see a difference in fitness also..
I would advise you to maintain some exercise...do you have a bike at home that you can use if weather or other factors don't allow you to cycle? Cycling outside does offer a better workout as it applies some resistance and this will help strengthen muscles more than using a bike at home but it will still help. Also it may be worth joining a gym or getting some advice on exercises you can do to maintain the strength you have now?
Can i ask..are you thinking about wen you get older, if exercise becomes limited?
I am 9 years post op and have never heard of incomplete or complete. I am not sure where I would be. I strain to pee, but mostly I cath. I don't usually leak in between, but I used to at night. I don't need help to have a BM. I have drop foot, saddle anesthesia and a permanent limp. Also pins and needles sometimes in legs, butI take very little in the way of pain control. So would I be considered incomplete? Just curious.
staceym do you know when you need to go pee? If you do them you are incomplete. If you retain and dont have the urge to pee at all then you are complete How much are you straining? Do you manage to void yourself enough to empty your bladder?
I don't understand why this classification is not discussed with us when we are diagnosed with CES. Its just typical with the lack Of information that is provided in general. I found it very frustrating that there just isnt the answers out there :shrug: lara