Is there a single lesion that would explain fecal incontinence and urinary retention?

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Last updated: February 19, 2025View editorial policy

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Differential Diagnosis for Loss of Bowel Control and Urinary Retention

Single Most Likely Diagnosis

  • Cauda Equina Syndrome: This condition, often due to a herniated disk in the lower spine, compresses the nerves that control bowel and bladder function, leading to symptoms such as loss of bowel control and urinary retention. It is a common cause of these combined symptoms and requires urgent medical attention.

Other Likely Diagnoses

  • Spinal Cord Injury: Trauma to the spinal cord can result in damage to the nerves controlling bowel and bladder function, depending on the level and severity of the injury.
  • Multiple Sclerosis: This autoimmune disease can affect any part of the central nervous system, including areas responsible for bladder and bowel control, leading to a variety of neurological symptoms.
  • Spinal Stenosis: Narrowing of the spinal canal can compress the spinal cord or nerves, potentially affecting bladder and bowel control, especially if the narrowing occurs in the lower back.

Do Not Miss Diagnoses

  • Spinal Epidural Abscess: An infection in the space outside the sac that contains the spinal fluid can compress the spinal cord, leading to rapid onset of neurological deficits, including loss of bowel and bladder control. This condition is medical emergency.
  • Spinal Hematoma: Bleeding into the spinal canal can compress the spinal cord, leading to acute neurological symptoms. Prompt diagnosis and treatment are crucial to prevent permanent damage.

Rare Diagnoses

  • Tethered Cord Syndrome: A condition where the spinal cord becomes attached to the spine and is unable to move freely within the spinal canal, which can lead to a variety of neurological symptoms, including issues with bowel and bladder control.
  • Syringomyelia: A disorder in which a fluid-filled cavity forms within the spinal cord, potentially damaging the spinal cord from the inside out and leading to loss of bowel and bladder control among other symptoms.
  • Neurosyphilis: A complication of untreated syphilis infection that can affect the spinal cord and lead to a range of neurological symptoms, including problems with bladder and bowel control.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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