Fowler's syndrome: a primary disorder of urethral sphincter relaxation

Abstract

Key content Urinary retention is a relatively uncommon presentation in young women. Women with Fowler's syndrome are often found to have an abnormally elevated urethral pressure profile, increased urethral sphincter volume and characteristically abnormal electromyography of the urethral sphincter. The only treatment that has been found to restore voiding in women with Fowler's syndrome is sacral neuromodulation. Sphincter injections of botulinum toxin are a possible outpatient‐based alternative. Learning objectives To review the typical symptoms and signs associated with Fowler's syndrome. To share the current understanding about why this condition may occur. To understand how to evaluate and treat a woman with suspected Fowler's syndrome. Ethical issues Fowler's syndrome should be considered in women presenting with urinary retention where the cause for retention is uncertain.