[BLADDER OUTLET OBSTRUCTION (SUSPICIOUS FOR FOWLER'S SYNDROME) IN A WOMAN IN HER FORTIES: A CASE REPORT]

Dysuria is caused by bladder outlet obstruction (BOO) and detrusor underactivity. Female BOO is often overlooked because it is difficult to diagnose a condition from history and symptoms alone. Fowler's syndrome is seen in young women and causes urinary retention due to a primary disorder of urethral sphincter relaxation. Although the level of evidence is still low, sacral neuromodulation or intra-sphincteric Botulinum toxin injection has been applied to Fowler's syndrome. A 44-year-old woman with a chief complaint of dysuria started clean intermittent catheterization because of urinary retention. Videourodynamics showed BOO, open bladder neck, and narrowing of the middle urethra during voiding, and MRI showed thickening of the urethral sphincter. A neurological examination was performed with no neurologic features, so the diagnosis of Fowler's syndrome was suggested. The possibility of a diagnosis of female BOO should always be kept in mind when a woman has dysuria, and urodynamic study or Videourodynamics should be considered.