Pregnancy Following Clam Cystoplasty and Mitrofanoff Procedure in a Patient With Fowler's Syndrome and Detrusor...

Fowler's syndrome causes urinary retention due to failure of the urethral sphincter to relax. Management aims for complete bladder emptying, typically via intermittent self-catheterization. If conservative treatment fails, detrusor overactivity with Fowler's syndrome may be managed surgically using clam cystoplasty and the Mitrofanoff procedure to increase bladder capacity and reduce pressure. We report a rare case of pregnancy in a woman with Fowler's syndrome and detrusor overactivity, who previously underwent clam cystoplasty and Mitrofanoff procedure. She had a continent, functional abdominal stoma for clean intermittent catheterization. Her pregnancy was complicated by recurrent urinary tract infections and bladder spasms requiring antibiotics. A planned cesarean section was performed at 35 weeks following steroid administration and discussion with the multidisciplinary team, resulting in the delivery of a live baby. This case illustrates pregnancy management complexities in these women, focusing on the need for individualized, multidisciplinary care.