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. 2018 Sep;44(9):1817-1823.
doi: 10.1111/jog.13711. Epub 2018 Jul 5.

Urogenital symptoms in women with Tarlov cysts

Molly Baker  1 , Machelle Wilson  1 , Stacey Wallach  1
Affiliations

Urogenital symptoms in women with Tarlov cysts

Molly Baker et al. J Obstet Gynaecol Res. 2018 Sep.

Abstract

Aim: To describe the clinical findings and urogenital symptoms associated with sacral perineural cysts (Tarlov cysts).

Methods: A retrospective chart review including 65 female patients with Tarlov cysts was completed. Clinical findings were collected from a database of subjects seen in our institution's urogynecology and neurosurgery clinics between 2004 and 2015. A statistical analysis was performed to test for any correlation between cyst size or location, and patient symptoms or examination findings.

Results: Tarlov cysts were most commonly located from S2 to S3 (73%), and ranged in size from 1 to 2 cm (55%). Frequently reported symptoms included lower back pain (83%, 95% confidence interval [CI] 0.71-0.91), lower extremity radiculopathy (75%, CI 0.63-0.85), positional pain (62%, CI 0.50-0.73), urinary urgency (54%, CI 0.41-0.66) and urinary frequency (48%, CI 0.35-0.61). Common urodynamic findings included an early sensation of filling (70%), involuntary detrusor contractions (33%), urethral instability (33%) and stress urinary incontinence (33%). A statistical analysis comparing cyst size and location to clinical findings was significant for a correlation between an S2 location and central nervous system symptoms (P = 0.02), larger cyst size and urinary dysfunction (P = 0.05) and smaller cyst size and an early sensation of filling (P = 0.05).

Conclusion: Patients with symptomatic sacral Tarlov cysts frequently report pain and neuropathy related to the lower back, pelvis and urogenital system. As compared to the general population, urinary urgency and urodynamic findings associated with urgency were more frequent in our patient sample. These findings suggest that Tarlov cysts may have a clinically significant impact on urogenital function.

Keywords: neurology; pelvic pain; sexual dysfunction; urinary incontinence; urodynamics.

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Conflict of interest statement

Conflict of interest: The authors report no conflicts of interest

Figures

FIGURE 1
FIGURE 1
Sagittal T2 weighted MRI of a Tarlov cyst (arrow) spanning the S2-S3 nerve root (A), and corresponding axial image showing the proximity of the nerve root (arrowhead) to the Tarlov cyst (B).
See this image and copyright information in PMC

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