Erectile Dysfunction as a Sentinel Presenting Feature of Cauda Equina Syndrome

Cauda equina syndrome is a neurosurgical emergency that can be a diagnostic challenge as no single history or examination feature has been found to be pathognomonic. We present the case of a twenty-seven-year-old male presenting only with erectile dysfunction and found to have critical cauda equina compression from a large disc prolapse. Whilst sexual dysfunction is a recognized complication of spinal cord injury, the prevalence of erectile dysfunction as a presenting symptom of cauda equina compression is not known. Sexual histories are often poorly taken by clinicians and this case highlights that erectile dysfunction
alone can signify cauda equina syndrome.