Symptoms and Signs of Cauda Equina Syndrome Cauda equina syndrome (like conus medullaris syndrome) causes distal leg paresis and sensory loss in the distribution of the affected nerve roots (often in the saddle area), as well as bladder, bowel, and pudendal dysfunction (eg, urinary retention, urinary frequency, urinary or fecal incontinence, erectile dysfunction, loss of rectal tone, abnormal bulbocavernosus and anal wink reflexes).