Non-invasive urodynamics in Fowler´s syndrome. A review at an urological center in the north of Mexico
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i2.829Keywords:
Fowlers Syndrome, pelvic floor electromyography, urinary retention, urinary infectionAbstract
Backround. In 1986, Fowler et al. described a syndrome in which young women suffered of an unexplained urinary retention associated to a weak relaxing external urethral sphincter. Electromyographic studies have shown an abnormal activity of the urethral sphincter in Fowler´s Syndrome women, suggesting that urinary retention is due to an ephaptic transmission of impulses between their muscle fibers. However, this syndrome is yet unknown and underdiagnosed.
Objective. To know the micturition characteristics and uroflowmetry of Fowler´s Syndrome patients attended at the Centro de Urología Avanzada CURA at Delicias city, Chihuahua, Mexico, from January 2018 to January 2021.
Material and methods. Clinical records were examined from patients who attended the consultation and were diagnosed with the Fowler´s Syndrome. The demographic characteristics, evolution time process, mayor symptoms, residual post-voiding volume, bladder diary and the uroflowmetry using surface EMG, were determined.
Results. Ten women were diagnosed with the Fowler´s Syndrome and presented a clinical record of acute urinary retention (AUR). The mean age was 41.4 ±17.51 years old and the mean of the syndrome evolution was 31.2±23.46 mo. The mean urinary frequency was 14.2±4.75 micturitions/24h, the mean of the Qmax was 22.74±11.49 cc/s. the mean voided volume was 198.30±89.54cc and the mean of post void volume was 231.5±86.12 cc. EMG in all patients showed a hypertonic and lack of relaxation pattern.
Conclusions. In the clinic, Fowler´s syndrome exhibits chronic urinary retention with repetitive urinary infections without intravesical obstruction. Its diagnosis is possible through non-invasive urodynamic procedures such as uroflowmetry accompanied urethral surface EMG and post void volume assessment.
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