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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
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I went routine TVT insertion in a private hospital in

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I went for a routine TVT insertion in a private hospital in 2009. But that day i turned up i informed the anaesthetist that i had a fall 2 days before, i was in significant coccyx pain,but wasn't sure whether the coccyx injury would effect the surgery outcome. The anaesthetist was not happy for surgery to go ahead due to positioning and PO pain, unless i had a caudal block. As i had studied Anatomy and physiotherapy i was aware of caudal epidural injury and i flatly refused any form of epidural injection. There is no consent for it. Surgery went ahead. I was very seriously ill post operatively, and 3 days later had a haematoma which was left undiagnosed until i screamed and had emergency surgery. Moving on to today i have had severe leg nerve deficit, loss of Achilles tendon reflex and i am bladder and bowel incontinent. I have studied all my medical notes and found that both the anaesthetist AND the surgeon administered caudal block whilst i was under GA. Both of these CB's were done with my legs in lithotomy, and i have significant other stretch injuries to my buttocks and torn Rt hip cartillage. The nursing medical records state clearly that i was only ever in lithotomy position.It states i had one 15ml block and later a 10ml block. I have all the RED FLAG symptoms of CES, could these blocks to an undiagnosed injured spine have contributed to neaurogenic bladder, disabled bowel, leg weaknes, leg and buttock pain ?

During the surgery the surgeon also performed a Perreanophy and a very large rectocele +++ .Neither procedures were discussed or consented.

Submitted: 2 years ago.
Category: Medical
Expert:  Dr. P. Jyoti replied 2 years ago.
Hello,Firstly of course I must say that it is impossible now to determine retrospectively whether your CES could have been caused by a caudal block.But I must stress that it is very very unlikely.Caudal blocks nowadays are given by epidural blocks, ie, the anesthetic agent is injected in the epidural space.As you are aware in the caudal region the spinal cord has ended and it is only the individual nerves which are present in this region.Hence it would be very unlikely for the anesthetic needle to injure the nerves here. At most a single nerve might be injured, but for all the nerves to receive an injury is highly unlikely.Hence I would opine that your present CES was not from the blocks given at that time. The two are only coincidentally related.Disc lesions are the most likely cause of CES. Best would be to discuss with your doctor about doing an MRI of the spine. This will show up any lumbar disc lesion or any other potential causes of CES.Discuss this with your treating doctor. You will get more attention when you are able to ask informed questions. Ask about disc lesions and whether they are likely for you, and if so, ask for an MRI of the lumbar and sacral spine. Take care - wish you good health and a quick recovery.If the question has been answered to your satisfaction, you need to rate my service positively.Rating system is the row of stars above - click on at least 3 stars to give a good rating. Bonus is always welcome Thank you.Dr. P. Jyoti
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