A distal cauda equina lesion such as at S3/4/5 would explain isolated saddle anesthesia without hyper/hyporeflexia or weakness. Bladder continence is controlled by Onuf’s nucleus, located between S2/3/4, and thus would also be impacted. Although cauda equina can often be unilateral, it is difficult to discern unilaterality with distal sacral nerve roots as the dermatomes converge midline.