Fowler syndromeFowler’s Syndrome – Diagnosis & Treatment Urogynecology

Fowler’s syndrome is a cause of urinary retention. Urinary retention is the quite opposite of urinary incontinence. Women suffering from urinary retention have difficulty emptying their bladder even when the bladder signals that it is full and needs to empty. This is because the sphincter muscles around the urethra under the bladder that controls the opening and closing of the urethra don’t relax well to allow the passage of urine out of the bladder.

Fowler’s syndrome is typically seen in young women between 20 to 30 years of age. Polycystic ovaries are found to be the cause of Fowler’s syndrome in many women. There don’t seem to be any neurological disorders associated with Fowler’s syndrome.

Symptoms of Fowler’s syndrome

Urinary retention is the first big symptom that can’t be ignored in people suffering from Fowler’s syndrome. However, the severity of the problem varies from person to person. Along with urinary retention, the following symptoms can also be seen (either mild or severe):

  1. Inability to feel that the bladder is full
  2. Severe pain in abdomen (because the bladder is full)
  3. Pain or difficulty to urinate, called Dysuria.
  4. PCOS – Polycystic Ovary Syndrome.  Typically women may experience heavy bleeding, irregular menstrual cycle when they are suffering from PCOS.
  5. Intermittent stream of urine while passing
  6. Inability to empty the bladder completely
  7. Urinary Infections due to retention of urine.

The severity of Fowler’s syndrome varies from mild, where the person is able to pass urine but with little difficulty to severe where the person is not able to pass any urine at all even when feeling the urge to urinate and the bladder is full.  Women with urinary retention issues may report recurrent cystitis (bladder infections) or kidney infections.

What causes Fowler’s syndrome?

The exact cause of Fowler’s syndrome is not known but it has been noted that nearly half of women who had Fowler’s syndrome also had PCOS. Retention of urine can also be caused by surgery in the abdominal area, childbirth, or a sudden onset of some other medical condition.

Diagnosis of Fowler’s syndrome

Usually, urogynecologists need a couple of visits to figure out the exact problem. Your urogynecologist will start with a series of questions to rule out all other possibilities that can cause urinary retention.

Your doctor will also test how much urine is being left out in the bladder after peeing. Depending on the quantity of urine retained, the severity of the issue may be ascertained.

Treatment of Fowler’s syndrome

  1. If the urine left out in the bladder is very less, your doctor wouldn’t really put you on any prescription.
  2. For people with severe condition, intermittent catheterization may be needed wherein a catheter is inserted into the bladder regularly to empty it.
  3. Scaral Nerve Stimulation – a device is placed in the body that can work on the nerves when the bladder is full. This surgery is not suitable for everyone.

Why you should not ignore urinary retention problem?

Retaining urine in the bladder for any reason is a bad idea. This can result in recurring urinary tract infections or can even cause kidney problems.  If you are having trouble passing urine and it’s been just a day or two, that’s ok but if you have been having the problem peeing with lower abdominal pain or lower back pain, consult your gynecologist immediately.

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