Fowler's syndrome

Fowler's syndrome, also described as a urethral sphincter relaxation disorder, is a rare condition in which the urethral sphincter fails to relax so that urine cannot be passed normally. It affects younger women, mostly between menarche and menopause, with a peak age of onset around 26, and abnormal electromyographic activity is found in the sphincter. The usual complaint is being unable to urinate for a day or more without any urge, even with a bladder volume above one litre, and about one third of women with urinary retention are reported to have it. Many also have chronic pain, and catheterisation is often very painful. The exact cause is not yet known; one hypothesis is a hormonally dependent channelopathy that over-excites the external sphincter muscle, and another involves raised spinal cord enkephalins. Diagnosis rests on urodynamic testing and electromyography, which show complex repetitive discharges. Sacral neuromodulation is described as the treatment that restores voiding. The condition is named for Clare Fowler. This entry records what the source states and is not medical advice.