Cauda equina nerve compression causing anal swelling sensation needs to be promptly treated by surgery to release the compression, the specific surgery needs to be carried out after the doctor’s evaluation. Cauda equina compression is usually caused by lumbar disc herniation, after the nerve is compressed, it will be manifested as anal distension, and in serious cases, acute urinary retention and sexual dysfunction may occur, which need to receive timely treatment. Surgery is preferred to remove the compressed nerve after compression of the cauda equina, and to treat the primary disease at the same time, to avoid further damage or even necrosis of the nerve. Surgery can promote the recovery of symptoms and improve the prognosis of the disease. Methylcobalamin and other drugs can also be taken to promote the recovery of damaged nerves, and the drugs need to be used under the guidance of a doctor. Regular postoperative checkups are required to monitor the changes in the body.