Fowler's syndrome and pregnancy

Area of Science:

• Urology
• Gynecology
• Neurology

Background:

• Fowler's syndrome is a rare condition causing painless urinary retention in young women.
• There is no definitive cure for Fowler's syndrome, emphasizing the need for effective bladder emptying strategies.
• Management options include self-catheterization, suprapubic catheters, and sacral nerve stimulation (SNS).

Observation:

• A pregnant woman with Fowler's syndrome initially managed with a sacral nerve stimulator (SNS).
• The SNS was deactivated during pregnancy due to safety concerns, necessitating management with a suprapubic catheter.
• The patient experienced recurrent urinary tract infections and pelvic pain during pregnancy.

Findings:

• The patient underwent an uncomplicated elective cesarean section at 36 weeks, delivering a healthy infant.
• Postnatally, the SNS was successfully reactivated, and the suprapubic catheter was removed.
• Adequate urethral output was achieved after SNS reactivation.

Implications:

• This case highlights the successful management of Fowler's syndrome during pregnancy, balancing safety and bladder function.
• It demonstrates the feasibility of using sacral nerve stimulation for Fowler's syndrome in pregnant patients.
• Effective management strategies are crucial for improving the quality of life for women with Fowler's syndrome during pregnancy and postpartum.