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Fowler's Syndrome--a Cause of Unexplained Urinary Retention in Young Women?

Overview
Journal Nat Rev Urol
Specialty Urology
Date 2013 Dec 11
PMID 24323131
Citations 27
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Abstract

Urinary retention in women is an uncommon and poorly understood condition. In 1986, Fowler and colleagues described a syndrome in young women with unexplained urinary retention associated with polycystic ovary syndrome. The underlying abnormality was a poorly relaxing external urethral sphincter that when studied using concentric needle electromyography showed a distinct abnormal pattern suggesting direct spread of impulses between muscle fibres. These findings were subsequently reproduced by other researchers and in larger patient cohorts, but remain the subject of much debate. A poorly relaxing sphincter is thought to cause increased urethral afferent activity, which inhibits bladder afferent signalling leading to poor bladder sensation and detrusor underactivity. Most studies of Fowler's syndrome are limited due to small cohorts with no control group and a lack of videourodynamic data. Whether Fowler's syndrome represents a distinct cause of urinary retention or results from a maladaptive behaviour and is similar to dysfunctional voiding is unclear. Application of sacral neuromodulation in patients diagnosed with Fowler's syndrome can restore normal voiding, in the absence of any effective pharmacotherapy or surgical treatment.

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References
1.
Pannek J, Einig E, Einig W . Clinical management of bladder dysfunction caused by sexual abuse. Urol Int. 2009; 82(4):420-5. DOI: 10.1159/000218531. View

2.
Crayton R, Soller W, Mattiasson A, Bossowska A, Borkowski T, Majewski M . Exogenously administered opioids contract the female rat intrinsic urethral sphincter in vivo. Neurourol Urodyn. 2009; 29(5):777-82. DOI: 10.1002/nau.20822. View

3.
Kavia R, Datta S, Dasgupta R, Elneil S, Fowler C . Urinary retention in women: its causes and management. BJU Int. 2006; 97(2):281-7. DOI: 10.1111/j.1464-410X.2006.06009.x. View

4.
Lapointe S, Rivet C, Goulet O, Fekete C, Lortat-Jacob S . Urological manifestations associated with chronic intestinal pseudo-obstructions in children. J Urol. 2002; 168(4 Pt 2):1768-70. DOI: 10.1097/01.ju.0000028495.91112.98. View

5.
de Groat W, Fraser M, Yoshiyama M, Smerin S, Tai C, Chancellor M . Neural control of the urethra. Scand J Urol Nephrol Suppl. 2001; (207):35-43; discussion 106-25. DOI: 10.1080/003655901750174872. View