Fowlers Syndrome

Fowler’s Syndrome is a long term condition causes full or partial urinary retention (urine stays in the body or one can only do a little, leaving a lot of urine behind in the bladder) and solely affects women mainly in young female adults (age of 20-30s).

• To pass urine, one needs to send signals from the brain to the urethral sphincter (this is the circular muscle that surrounds the opening to your bladder, the muscle that keeps you continent- hold urine in) and for this muscle to relax.
• The problem is caused by the sphincter’s failure to relax and thus allow urine to be passed normally.
• This is not classed a urological, gynaecological or  a neurological condition (where there is a problem with the signal between the brain and sphincter’s muscle), instead its an unknown cause on why sphincter’s muscle does not relax and  and coordinating urination, (research is still ongoing out on whether the return signal from the bladder to the brain is not activating fully).
• This is not a form of incontinence, but can be  mistaken for that.
• This is a difficult condition to diagnose.

Diagnosis test

• Elevated urethral pressure profile – this test measures the pressure in the water-pipe
  (urethra) sphincter muscle, as a catheter is inserted and withdrawn several times
• Abnormal findings in urethral sphincter electromyography including decelerating bursts
• Evidence for bladder outflow obstruction on video urodynamics testing (This involves measuring the pressure inside the bladder as it fills and
  looking at how it works when you are trying to pass urine. When this is combined
  with x-rays it is called video urodynamics)
• Increased sphincteric volume on imaging
• Bladder Ultrasound – can see how much urine is left in your bladder after you try to
  pee
• Cystoscopy – is a camera test done to look inside the bladder for any problems
• Sphincter EMG (Electromyogram). This records electrical activity in the urethral
  sphincter.
• Ultrasound of the sphincter – this can help measure the size of the sphincter which
  may help work out what has gone wrong