Tarlov Cysts: Urinary Issues and Neurological Concerns

There is a 2 cm Tarlov cyst at the S1-S2 level?

Three years ago, I fell and landed on my buttocks, after which I discovered a cyst measuring 2.x cm at the S1-S2 level of my spine.
I consulted a doctor who diagnosed it as a Tarlov cyst, and I have been under observation since then.
However, two days ago, I wet the bed in the morning, but I woke up as soon as I urinated a little and got up immediately.
At that moment, I felt I should have been able to control it.
I thought I was just half-asleep.
But two days later, the same thing happened again; I woke up right after urinating a few drops.
During the day, I go to the bathroom less frequently.
I usually don’t feel urgency until I reach the bathroom door or get in front of the toilet, at which point I suddenly feel a strong urge, as if I'm about to wet myself.
It's quite embarrassing to still wet the bed as an adult.
However, I am a bit worried that this situation might happen again, and I am concerned whether this is related to the Tarlov cyst.
Doctor, are these issues related to my Tarlov cyst?

Wen, 30~39 year old female. Ask Date: 2021/09/21

Dr. Zhao Shaoqing reply Neurosurgery

A 2 cm tumor on the vertebra may cause symptoms if there is pressure, leading to the need for hospitalization for examination and evaluation.
If there are issues with bowel or bladder function, it is recommended to visit an outpatient clinic to assess the possibility of surgery.

Reply Date: 2021/09/21

More Info

Tarlov cysts, also known as perineural cysts, are fluid-filled sacs that occur on the nerve roots of the spine, most commonly in the sacral region (S1-S2). While many individuals with Tarlov cysts remain asymptomatic, some may experience a range of neurological symptoms, including urinary issues. Your concerns about recent urinary incontinence and urgency, particularly the episodes of bedwetting, are valid and warrant further exploration.

The relationship between Tarlov cysts and urinary dysfunction stems from the cysts' potential to compress nearby nerve structures. The sacral nerves play a crucial role in bladder control, and any disruption in their function can lead to symptoms such as urgency, frequency, and incontinence. In your case, the sudden onset of bedwetting and the urgency you experience when approaching the bathroom could be indicative of nerve involvement due to the cyst.

1. Urinary Symptoms: The fact that you are experiencing urgency only when you are close to the bathroom suggests a possible overactive bladder or detrusor instability, which can be associated with neurological conditions. The episodes of bedwetting, especially if they are new, could indicate that the nerve pathways responsible for bladder control are being affected by the cyst. It is important to note that while Tarlov cysts can contribute to these symptoms, other factors such as anxiety, stress, or even urinary tract infections should also be considered.

2. Neurological Concerns: Given that Tarlov cysts can lead to neurological symptoms, it is crucial to monitor any changes in your condition. If you notice an increase in urinary frequency, urgency, or incontinence, it may be necessary to consult a urologist or a neurologist who specializes in spinal disorders. They can perform a thorough evaluation, which may include imaging studies (like MRI) to assess the cyst's size and its impact on surrounding structures.

3. Management and Treatment: Management of urinary symptoms related to Tarlov cysts may involve a multidisciplinary approach. Behavioral modifications, such as bladder training and pelvic floor exercises, can be beneficial. Medications that help manage overactive bladder symptoms, such as anticholinergics, may also be considered. In some cases, if the cyst is causing significant symptoms or complications, surgical intervention may be necessary to decompress the affected nerves.

4. Psychological Impact: It is understandable to feel embarrassed about bedwetting as an adult. This condition can have psychological effects, leading to anxiety and social withdrawal. It is important to address these feelings and seek support if needed. Speaking with a healthcare professional can help you navigate these emotional challenges.

In conclusion, while your urinary symptoms may be related to the Tarlov cyst, it is essential to conduct a comprehensive evaluation to rule out other potential causes. Keeping a symptom diary, noting the frequency and circumstances of your urinary episodes, can provide valuable information for your healthcare provider. Regular follow-ups with your physician are crucial to monitor the cyst and any associated symptoms. Don't hesitate to reach out for help; urinary issues are common and treatable, and addressing them can significantly improve your quality of life.

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