Complications
Bladder/lower urinary tract dysfunction has been reported at follow-up for between 38% and 76% of patients after surgery for CES.[46][55] Symptoms include overactive bladder, stress incontinence, and low stream.[46] It is more common in patients who had CES with retention before surgery than in those with incomplete CES. Bladder function should be monitored by long-term follow-up, and patients referred to incontinence and specialist urology services as needed.[32] If bladder catheterisation is needed, an intermittent catheter is preferred, as it is associated with lower rates of urinary tract infection and urethral trauma. An indwelling catheter may be used if intermittent catheterisation is not feasible.[50][51] Anticholinergic medications are often part of management. Invasive procedures may be considered for ongoing problems.[50][51]
Bowel dysfunction has been reported at follow-up for between 13% and 43% of patients after surgery for CES.[46][55] A bowel programme establishes a regular time to stimulate the bowels to cause a bowel movement. Establishing a bowel programme will help to prevent involuntary bowel movements, constipation, and impaction of the bowels. Laxatives and/or bowel evacuation may also be required.[52]
In one study, 70% of patients who had surgery for CES reported pain at follow-up (mean follow-up 43 months), most of whom had back pain.[46] Referral to pain management services should be considered for patients whose pain is significantly affecting their day-to-day lives.
In one study, 70% of patients who had surgery for CES reported sensory loss at follow-up (mean follow-up 43 months).[46]
In one study, 44% of patients who had surgery for CES reported leg weakness at follow-up (mean follow-up 43 months), including 13% who needed a walking aid to mobilise.[46]
Use of this content is subject to our disclaimer