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A Urologist’s Perspective on Pelvic Pain and Tarlov Cysts–Related Symptoms
- Dec 18, 2025
- 3 min read
People living with Tarlov Cyst Disease often hear the same frustrating message:
“Your symptoms don’t fit neatly into one box.” “Your imaging doesn’t explain your pain.” “This must be pelvic floor, bladder, or anxiety-related.”
That’s why a recent interview published by UroToday deserves attention from our community.
In this interview, Dr. Elise De — a urologist with extensive expertise in pelvic pain — openly acknowledges something Tarlov cyst patients have known for years:
Pelvic pain can be neurological — and Tarlov cysts are a real cause of sacral nerve pain.
Who Is Dr. Elise De — and Why Her Voice Matters
Dr. Elise De is not a fringe voice. She is:
A Professor of Urology, OB-GYN, and Neurology
Medical Director of a Multidisciplinary Pelvic Health Service
A national educator for urologists and pelvic pain specialists
A contributor to clinical guidelines and training curricula
In other words, she teaches doctors how to think about pelvic pain.
When someone with this level of training and influence includes Tarlov cysts in a medical discussion, it matters — especially for patients who have been dismissed or misdiagnosed.
What She Said — in Plain Language
In the interview, Dr. De explains how doctors should evaluate chronic pelvic pain. One of her most important points is this:
Not all pelvic pain comes from the bladder, pelvic floor, or pudendal nerve.
She explains that when pelvic pain:
Extends beyond the pelvis
Travels into the legs
Follows sacral nerve patterns (especially S2–S3)
Doctors should stop assuming it’s “just pelvic” and start thinking about sacral nerve root problems, including:
Tarlov Cysts
She specifically names Tarlov cysts as a cause of sacral radiculopathy and identifies Dr. Rudy Schrot and Dr. Frank Feigenbaum as recognized experts in surgical treatment.
That is a clear acknowledgment that:
Tarlov cysts can cause real neurological symptoms
These symptoms are not imaginary, incidental, or purely functional
There are specialists who understand this condition
Why This Is So Important for Patients?
Many people with Tarlov cysts are told they have:
Pudendal neuralgia
Pelvic floor dysfunction
Interstitial cystitis
“Unexplained” pelvic pain
Dr. De makes an important distinction that helps explain why so many patients get stuck:
Pudendal pain ≠ Sacral nerve pain
Pudendal neuralgia usually stays in the genital and perineal area
Sacral nerve pain often includes pelvic pain plus leg pain, bladder/bowel issues, and neurological symptoms
When pain goes beyond the pudendal nerve distribution, Dr. De says clinicians must look higher — at the sacral nerve roots and this is exactly where Tarlov cysts live.
A Snippet You Can Share or Highlight
“When pelvic pain extends beyond the pudendal nerve and follows sacral nerve patterns, clinicians should consider sacral radiculopathy — including Tarlov Cysts.” — Dr. Elise De, Urologist & Pelvic Pain Specialist
This is not patient speculation. This is medical teaching.
What Patients Can Take to Appointments
Here’s a simple takeaway patients can bring to urology or neurology visits:
“My pain isn’t limited to the pelvic floor or pudendal nerve. It follows sacral nerve patterns and includes neurological symptoms. I’d like to discuss whether sacral radiculopathy — including Tarlov cysts — could be contributing.”
You do not need to argue. You do not need to self-diagnose. You are asking for appropriate consideration, based on a published medical discussion.
Why the Tarlov Cyst Society Is Sharing This
This interview obviously doesn’t solve everything — and it doesn’t replace a specialized evaluation. But it does something powerful:
It validates patient experiences
It confirms Tarlov cysts belong in serious pelvic pain discussions
It shows that forward-thinking clinicians are paying attention
Every time a respected medical professional says these types of things out loud, it becomes harder for the medical system to ignore.
And that matters — for diagnosis, for referrals, and for patient dignity.
If you’re navigating pelvic pain, bladder issues, leg pain, or neurological symptoms and have been told “nothing explains this,” know this: your experience fits within real medical science — and voices like this help move care forward.
Click Here to watch the full video
Biography:
Dr. Elise De, MD, Professor of Urology, Ob/GynNeurology, Medical Director, Multidisciplinary Pelvic Health, Albany Medical College, Albany, NY