Sacral nerve root cysts - a rare cause of bladder dysfunction.]
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Aktuelle Urol. 2006; 37(5):372-5 (ISSN: 0001-7868)
Kümpers P; Wiesemann E; Becker H; Haubitz B; Dengler R; Zermann DH
Abteilung Nephrologie, Medizinische Hochschule Hannover, Hannover.

INTRODUCTION: Asymptomatic cysts of the sacral nerve roots display a prevalence of 5 % and are occasionally demonstrated by MRI of the spine. Depending on their size and localization, arachnoid cysts may cause sacral or perineal pain, radicular sensomotory symptoms and neurogenic bladder and bowel dysfunction by compression of the nerve roots. CASE REPORT: We report on a case of a recently developed neurogenic bladder dysfunction. MRI of the spine demonstrated two large, liquor-filled cysts of 2.5 and 3 cm diameter, bilaterally localized at the nerve roots S2/3. Neurological and urological examinations confirmed the diagnosis of symptomatic nerve root cysts at the level S2/3, resulting in detrusor areflexia. A microsurgical excision of the cysts ameliorated the patient's pain symptoms. However, the detrusor areflexia did not improve. CONCLUSIONS: Tarlov cysts are predominantly regarded an asymptomatic incidental feature of CT and MRI scans of the spine. The case of our patient, as well as the so far published reports indicate, however, that a Tarlov cyst may cause a variety of neurological and urological symptoms. Nerve root cysts should be seriously considered and not excluded at an early stage, especially when coincident with persistent neurological and urological symptoms.

I am lost, I've been without the control of my bladder for over 4 months. I am a healthy 54 year old male, a bad golfer who thought all of this was the result of two bad days in a row on a golf course. I'd never had anything like this happen before and after 3 months I lost my bladder, holding upto 1500 mls in my bladder with no pain or sensation. After passing out from abdominal spasms and being brought by EMTs to a hospital ER, I have been slowly referred from doctor to doctor and have undergone a number of tests: ct scan, mri's, bladder stop/fill/function, urodynamics, spinal tap, evoked potenials. Thus far the only diagnosis is they see no tumors, not MS, I have spinal stenosis and a referral to another neurologist. For the most part the doctors seem more concerned with pain control than me getting my bladder back and urinating normally. Don't get me wrong, but if possible I'd like my life back and want to more freely live again?

Does anyone have any thoughts?

Many thanks in advanced.