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Tarlov Cysts and Sexual Dysfunction: A Multidisciplinary Breakthrough in Care
- 6 days ago
- 2 min read
Published: The Spine Journal, 2025
Lead Author: Dr. Shashank Coorapati, MD
Understanding the Connection between Tarlov Cyst and Sexual Dysfunction
For many years, patients living with Persistent Genital Arousal Disorder (PGAD) or Genito-Pelvic Dysesthesia (GPD)—conditions marked by chronic, unrelenting genital arousal and pain—were left without answers. In 2012, researchers Komisauk and Lee discovered that sacral Tarlov cysts appeared in a striking number of these patients, revealing a neurological link that had never been considered before.
Building on that discovery, Dr. Shashank Coorapati and an international team of experts in sexual medicine, urology, neurophysiology, and spine surgery developed a multidisciplinary diagnostic and surgical protocol to evaluate and treat patients suffering from Tarlov Cysts and Sexual Dysfunction.
About the Study
This 2025 study reviewed the outcomes of 19 patients treated surgically between 2017 and 2023 for symptomatic Tarlov cysts causing PGAD/GPD. Each patient underwent a detailed work-up that included:
Neurogenital testing and MRI review of the sacral spine
Targeted diagnostic injections to confirm the cyst as the pain source
Excision and imbrication surgery for cyst removal and nerve decompression
Researchers then assessed patient improvement using validated outcome tools, including the Patient Global Impression of Improvement (PGI-I), Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for pain, and the Sexual Distress Scale-Revised (SDS-R).
Key Results
74% of patients reported meaningful postoperative improvement.
2 patients (10.5%) were “very much better”
9 (47.4%) “much better”
3 (15.8%) “a little better”
No patients reported worsening.
No cerebrospinal fluid leaks, wound issues, or cyst recurrences were observed.
All patients were discharged the same day—an exceptional safety profile for spinal surgery.
Why This Matters
This research confirms that Tarlov cysts can directly affect the nerves responsible for pelvic sensation and sexual function, leading to severe and distressing symptoms that mimic or cause PGAD/GPD.
The multidisciplinary approach used in this study—combining specialized neurogenital testing, targeted diagnostic blocks, and surgical precision—offers new hope for patients whose conditions have long been misunderstood or dismissed.
It also underscores a vital point: early recognition of symptomatic Tarlov cysts allows for more targeted, effective, and safer surgical outcomes.
Implications for Patients and Clinicians
For patients living with unexplained pelvic pain or genital dysesthesia, this research highlights the importance of:
Comprehensive sacral MRI review for Tarlov cysts
Neurological assessment of pelvic nerves
Collaborative care among spine surgeons, urologists, and sexual-medicine specialists
For clinicians, it reinforces the need to consider Tarlov cysts as a potential cause of pelvic neuropathy and to refer patients to teams experienced in both diagnostic evaluation and surgical management.https://doi.org/10.1016/j.spinee.2025.08.196
Moving Forward
The Tarlov Cyst Society celebrates this milestone in multidisciplinary research and encourages both patients and professionals to share it widely. It represents another step toward evidence-based recognition of Tarlov Cyst Disease as a legitimate neurological condition affecting pain, function, and quality of life.
You can explore this study in detail here:🔗 Read the Publication on ScienceDirect
Learn More and Stay Connected
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