one for the ladies - fowlers

ladies if you have fowlers syndrome then do come on board and share with others out there.

What is Fowler’s Syndrome?

First described in 1985, it is a cause of urinary retention in young women. Urinary retention in young women is not common but can be quite debilitating. The abnormality lies in the urethral sphincter. The problem is caused by the sphincter’s failure to relax to allow urine to be passed normally. There is no neurological disorder associated with the condition. Up to half the women have associated polycystic ovaries.

The typical woman who is seen with the condition is in her 20-30s and may infrequently pass urine with an intermittent stream. The normal sensation of urinary urgency expected with a full bladder are not present but as the bladder reaches capacity there may be pain and discomfort, and she finds that she is not able to pass urine. This can happen spontaneously or following an operative procedure (gynaecological, urological or even ENT) or following childbirth.

If the retention occurs after an operation in hospital, urinary retention may occur during the night after the operation when the patient develops pain over their bladder.

Initial hospital management is carried out by the urology team at the local hospital but if the symptoms do not resolve, the patient maybe referred on.

Many women who are not in complete retention, may present to they doctors complaining of recurrent cystitis (bladder infections) or even kidney infections.


What causes these symptoms?

Most of symptoms of Fowler’s Syndrome are caused by inability to empty the urine that is stored in the bladder.

Some women may experience back pain, suprapubic pain (pain over the bladder) or dysuria (discomfort/burning whilst passing urine) due the urinary infections.

The cause and process which gives rise to Fowler’s Syndrome is not known and is still under research.

Are there any treatments?

Currently the treatments for Fowler’s syndrome are being researched and developed. Depending on the severity of the condition, there are various but limited options.

Often patients have a poor urine stream but can still void almost normally. Some patients have a large residual volume which gives rise to urinary infections and a large bladder. These patients are helped by regular clean intermittent catherisation.

The most severe patients, those in complete retention may be candidates for sacral nerve stimulation, which is the only treatment shown to restore voiding.

Who can I see for help?

General Practitioner – will be able to advise or refer patients.
Continence Adviser – teach clean self intermittent catherisation techniques, advice on catheters, moral support.
Consultant Urologist – local urologist may have experience on Fowler’s Syndrome may refer on to Specialist unit such as National Hospital.