Urinary retention in women

2017 ◽  
Author(s):  
Clare J. Fowler ◽  
Jalesh N. Panicker
Keyword(s):  
Urinary Retention ◽  
Young Woman ◽  
Young Women ◽  
Emg Activity ◽  
Urethral Sphincter ◽  
Polycystic Ovaries ◽  
Medical Opinion ◽  
Positive Identification ◽  
Striated Urethral Sphincter ◽  
Fowler’S Syndrome

If a young woman in complete urinary retention is investigated and all urological and neurological investigations are found to be normal, the commonest diagnosis then made is Fowler’s syndrome (FS). Described by Fowler et al. in 1987, the original syndrome comprised of complete urinary retention with the finding of a particular pattern of electromyographic (EMG) activity recorded with a concentric needle electrode from the striated urethral sphincter, in a young woman with clinical features of polycystic ovaries. Prior to that, description medical opinion was that urinary retention in young women was due to ‘hysteria’; more had been written about ‘psychogenic urinary retention in women’ than any other possible causes. Twenty-five years on, the situation now seems to be that if neither the urologist or urologist can discover an underlying abnormality, the woman may be told she has FS without any positive identification of that condition.

Isolated urinary retention in young women, or Fowler's syndrome

2001 ◽  
Vol 11 (5) ◽  
pp. 309-311 ◽  
Author(s):  
Michael J. Swinn ◽  
Clare J. Fowler
Keyword(s):  
Urinary Retention ◽  
Young Women ◽  
Fowler’S Syndrome

scholarly journals Chronic Urinary Retention due to Fowler's Syndrome

2018 ◽  
Vol 06 (01) ◽  
pp. e77-e80
Author(s):  
Jan Trachta ◽  
Johann Wachter ◽  
Jan Kriz
Keyword(s):  
Urinary Retention ◽  
Clinical Symptoms ◽  
Clean Intermittent Catheterization ◽  
Urethral Pressure ◽  
Polycystic Ovaries ◽  
Acute Cystitis ◽  
Teenage Girls ◽  
Chronic Urinary Retention ◽  
Tract Infections ◽  
Fowler’S Syndrome

AbstractFowler's syndrome (FS) is a rare cause of chronic urinary retention in teenage girls and young women. We present a case of a 14-year-old girl who presented at our hospital 2 weeks after uncomplicated laparoscopic appendectomy. The girl complained of reduced urinary frequency and prolonged micturition time. Following an acute cystitis 2 months later, she completely lost her ability to void. A comprehensive set of investigations to assess the cause of her urinary retention including a cerebral and spinal magnetic resonance imaging (MRI), and videourodynamics were performed. The diagnostic workup revealed polycystic ovaries and an asensitive and hypotonic bladder with capacity up to 1200 mL and high maximum urethral pressure of 120 cm of water. She did not tolerate clean intermittent catheterization; therefore, a suprapubic catheter was placed. Under this treatment, she suffered recurrent urinary tract infections. Two years later, she was diagnosed with FS on the basis of the medical history, clinical symptoms, and urodynamic findings. Finally, the implantation of a S3 neurostimulator restored her ability to void.

scholarly journals Fowler’s Syndrome—The Cause of Urinary Retention in Young Women, Often Forgotten, but Significant and Challenging to Treat

2021 ◽  
Vol 18 (6) ◽  
pp. 3310
Author(s):  
Jacek K. Szymański ◽  
Aneta Słabuszewska-Jóźwiak ◽  
Grzegorz Jakiel
Keyword(s):  
Urinary Retention ◽  
Young Women ◽  
Sacral Neuromodulation ◽  
Polycystic Ovary ◽  
Pelvic Floor Muscle ◽  
Muscle Membrane ◽  
Urinary Continence ◽  
Detrusor Underactivity ◽  
Diagnostic Challenge ◽  
Fowler’S Syndrome

Urinary retention in young women is a relatively rare clinical problem and is often underdiagnosed. In particular, functional causes of urinary retention pose a diagnostic challenge. One of them is Fowler’s syndrome, which is associated with impaired urethral relaxation. Fowler’s syndrome is characterized by a large bladder capacity, reduced sensation, increased maximal urethral closure pressure, and detrusor underactivity. Several hypotheses have arisen to explain the cause of urethral relaxation disorders: hormonal changes characteristic of Polycystic Ovary Syndrome (PCOS), causing abnormal stabilization of the muscle membrane, primary failure of relaxation of the striated muscle of the urethra sphincter, and increased urethral afferent activity, inhibiting the bladder afferent signals from reaching the brain by potentiating a spinal mechanism of urinary continence. Currently, sacral neuromodulation is the only intervention that can restore an atypical voiding pattern in women with Fowler’s syndrome. The therapeutic effectiveness exceeds 70%, although the revision rate is relatively high, exceeding 50%. Well-designed, long-term prospective studies comparing sacral neuromodulation (SNM) with other therapies such as pelvic floor muscle physiotherapy are warranted to offer the best patient-tailored treatment.

Fowler's syndrome—a cause of unexplained urinary retention in young women?

2013 ◽  
Vol 11 (2) ◽  
pp. 87-98 ◽  
Author(s):  
Nadir I. Osman ◽  
Christopher R. Chapple
Keyword(s):  
Urinary Retention ◽  
Young Women ◽  
Fowler’S Syndrome

scholarly journals Subinvolution of the placental site as the cause of hysterectomy in young woman

2021 ◽  
Vol 14 (2) ◽  
pp. e238945
Author(s):  
Olga Triantafyllidou ◽  
Stavroula Kastora ◽  
Irini Messini ◽  
Dimitrios Kalampokis
Keyword(s):  
Young Woman ◽  
Young Women ◽  
Postpartum Haemorrhage ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Retained Products Of Conception ◽  
Products Of Conception ◽  
Fertility Sparing ◽  
Placental Site ◽  
Retained Products

Subinvolution of placental sites (SPSs) is a rare but severe cause of secondary postpartum haemorrhage (PPH). SPS is characterised by the abnormal persistence of large, dilated, superficially modified spiral arteries in the absence of retained products of conception. It is an important cause of morbidity and mortality of young women. In this study, we present a case of secondary PPH in a young woman after uncomplicated caesarean delivery who was deemed clinically unstable, and finally, underwent emergent total abdominal hysterectomy. We reviewed the literature with an emphasis on the pathophysiology of this situation. Treatment of patients with SPS includes conservative medical therapy, hysterectomy and fertility-sparing percutaneous embolotherapy.

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