Restless genital syndrome
In a report recently published in the journal JAMA Neurology, a condition little-known to doctors, characterized by intrusive anxiety symptoms in the groin area, was described and separated into an independent nosological form very recently.
An interview conducted by a Medscape contributor with the author of this report, Camila Henriques De Aquino, MD, outlines the main issues surrounding this new disease, dubbed Restless Genital Syndrome.
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Medscape /M/: Until the end of 2014, when your report was published, the term “restless genital syndrome” had never been found in the medical literature. What is this disease?
Dr Henriques De Aquino: It is a somatosensory disorder characterized by unpleasant sensations in the genital area and pelvis.
We define it as spontaneous, intrusive and unwanted sexual arousal, accompanied by tingling and throbbing, that occurs in the absence of any direct sexual desire or direct cause of sexual arousal.
M: When was the CIS first described?
Dr Henriques De Aquino: This syndrome was first described in 2001 and was called “persistent sexual arousal syndrome”, PSAS/.
Later in 2003, it was found that these symptoms were related to a sensory pathology of the genital organs, not sexual attraction, and the name of the syndrome was changed to “persistent genital arousal disorder” “, PGAD/.
Finally, in 2009, by analogy with restless legs syndrome, the final name of this pathological condition was adopted – “Restless genital syndrome”, RGS/.
M: What clinical symptoms characterize this disorder and how do doctors determine its presence?
Dr Henriques De Aquino: Patients with this pathology are troubled by persistent unpleasant sensations in the genital area, which can be characterized as burning, tingling, pain, itching and/or pulsations.
Patients often say – “it’s hard for me to find words to describe what I feel”. It has been found that these symptoms usually worsen when lying down or sitting, especially in the evening, and vice versa – prolonged standing or walking brings relief to patients.
In some cases, patients report a desire to stand up and move around at the beginning of the “attack” of discomfort in the perineum, which can be considered a key factor in making a diagnosis of CIS.
Patients with such symptoms usually turn to gynecologists, urologists and family doctors for help.
They need to be familiar with this disease in order to be able to suspect it in time and prescribe treatment that contributes to a significant improvement in the patient’s quality of life.
Some scientists associate the pathogenesis of CIS with neuropathy of the genital or clitoral nerve. But this is only a guess, at the moment no fundamental research has been conducted on this topic.
M: What are the modern approaches to the treatment of CIS
Dr Henriques De Aquino: Taking into account the fact of the similarity of the supposed pathogenesis of Restless Genital Syndrome with that of Restless Legs and therefore the treatment may be identical.
In our experience, administration of dopamine antagonists such as pramiprexol can be effective.
