Fowler's Syndrome: diagnostic and therapeutic challenge.

Mafalda Bártolo, Lília Martins, Fernando Martins

Abstract


Urinary retention in women is not a common complaint. The main causes are structural or functional, which means that urological and neurological reviews are mandatory. Fowler's Syndrome has been described in 1988 and has stablished an association between urinary retention, electromyographic abnormality of the striated urethral sphincter and polycystic ovaries pathologies. Even though its phisiopathology is not completely understood, this disorder seems to be due to a primary failure of relaxation of the striated urethral sphincter. Not only a typical clinical history, but also the evaluation of the sphincter volume, sphincter pressure profilometry and electromyography are determinant to the diagnosis. Sacral neuromodulation seems to be the only therapeutic intervention that can restore voiding. Nevertheless an important group of women still need intermittent self-catheterization. We report the case of an otherwise healthy young women with isolated urinary retention, which exemplifies the diagnostic and therapeutic challenge of Fowler's Syndrome.

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