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

Author(s):  
Jacek K. Szymański ◽  
Aneta Słabuszewska-Jóźwiak ◽  
Grzegorz Jakiel

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.

2001 ◽  
Vol 11 (5) ◽  
pp. 309-311 ◽  
Author(s):  
Michael J. Swinn ◽  
Clare J. Fowler

2013 ◽  
Vol 11 (2) ◽  
pp. 87-98 ◽  
Author(s):  
Nadir I. Osman ◽  
Christopher R. Chapple

Author(s):  
Clare J. Fowler ◽  
Jalesh N. Panicker

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.


2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Veronique Phe ◽  
Eskinder Solomon ◽  
Julie Jenks ◽  
Neha Sihra ◽  
Jalesh Panicker ◽  
...  

2021 ◽  
Vol 28 (2) ◽  
pp. 158-163
Author(s):  
Putri Iradita Islianti ◽  
Harrina Erlianti Rahardjo ◽  
Nur Rasyid ◽  
Arry Rodjani

Objective: This study aimed to describe the urodynamic characteristics of post-transplant kidney patients with LUTS who were indicated for urodynamics. Material & Methods: This research is a cross-sectional study conducted at Cipto Mangunkusumo General Hospital between 2011-2017. Data were collected from patients who had undergone urodynamic examination after kidney transplantation due to LUTS/urinary retention. Data were collected from the patient’s medical record. Results: A total of 536 patients underwent kidney transplants at Cipto Mangunkusumo General Hospital from 2011-2017. Eleven patients (2%) developed LUTS and then underwent urodynamic examination with an average age of 41.4 (30.1 ± 52.6) years. Six patients (55%) had type 2 diabetes mellitus (DM) and 5 patients (45%) had hypertension (HT). A total of 6 out of 11 patients (54%) experienced urinary retention of which 4 subjects (67%) had decreased bladder compliance, 4 (67%) patients experienced detrusor overactivity (DO), 3 patients (50%) had bladder outlet obstruction (BOO), while 2 patients (33%) experienced detrusor underactivity (DU) respectively. Of 5 patients without urinary retention, decreased bladder compliance was found in 1 patient (20%), DO in 2 patients (40%), BOO in 1 patient (20%), and no subject experienced DU. In both groups, no subject was discovered to experience any urinary incontinence. Conclusion: Small number of post renal transplantation patients developed LUTS and half of which accompanied by urinary retention. Among these patients, urodynamic examination revealed detrusor overactivity as the most common underlying problem followed by decreased bladder compliance, BOO, and detrusor underactivity


2017 ◽  
Vol 04 (01) ◽  
Author(s):  
Cihan Kaya ◽  
Hediye Dagdeviren ◽  
Caglar Helvacioglu ◽  
Huseyin Cengiz

2006 ◽  
Vol 0 (0) ◽  
pp. 061020035253002-??? ◽  
Author(s):  
Francesco Orio ◽  
Stefano Palomba ◽  
Francesco Giallauria ◽  
Annamaria Colao ◽  
Carlo Vigorito

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