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Fowler Syndrome

Table of Contents

Fowler Syndrome

Fowler Urethral Sphincter Dysfunction Syndrome; Fowler-Christmas-Chapple Syndrome

Fowler syndrome is a rare disorder in which the urethral sphincter fails to relax to allow urine to be passed normally. It mainly affects young women and can be a disabling condition. Explore symptoms, causes, and genetics of this condition.

Female Urinary System, including kidneys, bladder ureters and urethra

Image by TheVisualMD

About

Male and Female Urogenital System

Image by TheVisualMD

Male and Female Urogenital System

Male and Female Urogenital System

Image by TheVisualMD

What Is Fowler's Syndrome?

Fowler’s syndrome mainly affects young women and leads to the inability to empty the bladder (urinary retention). Many women have no other symptoms, although some women experience stomach pain. Fowler's syndrome is caused by spasms of the external urethral sphincter, a band of muscle that opens and closes at the exit of the bladder. The cause is unknown, but it has been known to occur after a surgical procedure, childbirth, opiate use, or other medical condition. Fowler's syndrome is difficult to diagnose, but many women with Fowler's syndrome have abnormal electrical activity on a specialized test called concentric needle electromyography. Fowler's syndrome is most often treated by using a device placed inside the body that helps stimulate the bladder.

Source: Genetic and Rare Diseases (GARD) Information Center

Causes

Unknown (película)

Image by Diseñadores publicitarios/Wikimedia

Unknown (película)

Logo de «Unknown».

Image by Diseñadores publicitarios/Wikimedia

What Causes Fowler's Syndrome?

The cause of Fowler's syndrome is not known. It is due to a spasm in a band of muscle that is found at the exit of the bladder, but what causes this muscle to spasm is unknown. Fowler's syndrome is seen more often in women who have had a surgical procedure, childbirth, opiate exposure or a sudden medical condition, such as an infection or illness.

Source: Genetic and Rare Diseases (GARD) Information Center

Symptoms

Artificial urethral sphincter - CT axial 001

Image by Hellerhoff/Wikimedia

Artificial urethral sphincter - CT axial 001

Sphincter implant/sphincter prosthesis of the urethra in a woman. Representation in computer tomography (axial): On the left the axial cuff around the urethra, on the right the intrapelvic reservoir and the connecting tubes to the pump.

Image by Hellerhoff/Wikimedia

What Are the Signs and Symptoms of Fowler's Syndrome?

Symptoms of Fowler’s syndrome may include:

Inability to pee (urinate)
Inability to feel that the bladder is full
Stomach pain

Fowler's syndrome usually occurs in women under the age of thirty. It may develop after a surgical procedure, childbirth, opiate use, or other sudden medical condition. Some women with Fowler's syndrome have polycystic ovaries. Because there are many causes for urinary retention (the inability to empty the bladder), Fowler's syndrome may be difficult to diagnose.

Source: Genetic and Rare Diseases (GARD) Information Center

Diagnosis

Electromyography

Image by D. Gordon E. Robertson

Electromyography

Electromyography during gait termination, Biomechanics Laboratory, University of Ottawa, Ontario, Canada

Image by D. Gordon E. Robertson

How Is Fowler's Syndrome Diagnosed?

Fowler’s syndrome is difficult to diagnose. Diagnosis usually involves ruling out more common causes of urinary retention (the inability to empty the bladder). In addition, it may be necessary to determine how much urine the bladder can hold without the person feeling like she has to go to the bathroom. In women with Fowler's syndrome, a test known as a concentric needle electromyography (EMG) often shows a characteristic abnormality.

Source: Genetic and Rare Diseases (GARD) Information Center

Electromyography

Electromyography

Also called: EMG, Electromyogram, Myogram, Muscle Activity Analysis

Electromyography (EMG) measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle. The test is used to help detect nerve and muscle problems.

Electromyography

Also called: EMG, Electromyogram, Myogram, Muscle Activity Analysis

Electromyography (EMG) measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle. The test is used to help detect nerve and muscle problems.

{"label":"Electromyogram reference range","description":"This test looks at the function of the nerve roots leaving the spine. It does this by looking at how well the electrical currents in the nerves are being transmitted to the muscles. The test is used to help detect nerve and muscle problems.","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"There is normally very little electrical activity in a muscle while at rest. Normal electrical activity is detected during muscle contraction.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An EMG can detect problems with your muscles during rest or contraction.","conditions":["Alcoholic neuropathy","Amyotrophic lateral sclerosis","Axillary nerve dysfunction","Becker muscular dystrophy","Brachial plexopathy","Carpal tunnel syndrome","Cubital tunnel syndrome","Cervical spondylosis","Common peroneal nerve dysfunction","Denervation","Dermatomyositis","Distal median nerve dysfunction","Duchenne muscular dystrophy","Facioscapulohumeral muscular dystrophy","Familial periodic paralysis","Femoral nerve dysfunction","Friedreich ataxiafunctions)","Guillain-Barr\u00e9 syndrome","Lambert-Eaton syndrome","Multiple mononeuropathy","Mononeuropathy","Myopathy","Myasthenia gravis","Peripheral neuropathy","Polymyositis","Radial nerve dysfunction","Sciatic nerve dysfunction","Sensorimotor polyneuropathy","Shy-Drager syndrome","Thyrotoxic periodic paralysis","Tibial nerve dysfunction"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
There is normally very little electrical activity in a muscle while at rest. Normal electrical activity is detected during muscle contraction.
Related conditions
You may need an EMG test if you have symptoms of a muscle or nerve disorder. These symptoms include:
- Muscle weakness
- Tingling or numbness in arms, legs, hands, feet, and/or face
- Muscle cramps, spasms, and/or twitching
- Paralysis of any muscles
- You will sit or lie on a table or bed.
- Your provider will clean the skin over the muscle being tested.
- Your provider will place a small needle with an electrode into the muscle. This is connected to a machine used to record your muscle's electrical activity when you move and relax it. You may have slight pain or discomfort when the electrode is inserted.
- You will stay still while the machine records your muscle activity at rest.
- You will tighten (contract) the muscle slowly while the machine records this muscle activity.
- The electrode may be moved to record activity in different muscles.
- The electrical activity is recorded and shown on a video screen. It looks like wavy and spiky lines. The activity may also be recorded and sent to an audio speaker. The audio may make popping sounds when you're contracting your muscles.
- An EMG test may take from 30 to 60 minutes.
If your results are not normal, it can be a sign of many different conditions. Depending on which muscles or nerves are affected, it could mean one of the following:
- Carpal tunnel syndrome, a common condition that affects nerves in the hand and arm. It causes numbness, tingling, weakness, or pain in your wrist or hand.
- Herniated disk, a condition that happens when a part of your spine, called a disk, is damaged. Part of the disk bulges or pushes out, putting pressure on the spine which causes pain and numbness.
- Guillain-Barré syndrome, a rare disorder that causes your immune system to attack your nerves. It can lead to numbness, tingling, and paralysis.
- Myasthenia gravis, a rare disease that causes weakness in the muscles you can control. They may include your muscles for eye movement, facial expressions, or other muscles.
- Muscular dystrophy (MD), a group of genetic diseases that cause muscle weakness. This weakness can lead to trouble walking and the ability to care for yourself.
- Charcot-Marie-Tooth disease (CMT), a group of nerve disorders that are inherited (passed down through families). CMT causes nerve damage and muscle weakness, mostly in the arms and legs.
- Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. It is a disorder that attacks nerve cells in your brain and spinal cord. It affects all the muscles you use to move, speak, eat, and breathe. There is no cure for ALS, and it gets worse over time.
To understand the results of an EMG test, your provider will consider your symptoms, medical history, and the results of other tests.
If you have questions about your results, talk to your provider.
1. Electromyography (EMG) and Nerve Conduction Studies: MedlinePlus Medical Test [accessed on Apr 17, 2024]
2. Electromyography: MedlinePlus Medical Encyclopedia [accessed on Oct 04, 2018]
3. Electromyography - Health Encyclopedia - University of Rochester Medical Center [accessed on Oct 04, 2018]
4. Electrodiagnostic Testing | EMG & NCV Tests | The Foundation For PN [accessed on Oct 04, 2018]
5. Neurological Diagnostic Tests and Procedures Fact Sheet | NINDS [accessed on Oct 24, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (9)

Electromyography

Electromyography during gait termination, Biomechanics Laboratory, University of Ottawa, Ontario, Canada

Image by D. Gordon E. Robertson

Electromyographic recording at adductor pollicis muscle and stimulation of the ulnar nerve

Electromyography is a form of quantitative neuromuscular function monitoring. Electromyography can be used to monitor the effects of and recovery from muscle relaxants when used as part of general anaesthesia.

Image by Paul Anthony Stewart/Wikimedia

Nerve conduction velocity (NVM) test

The photo shows the measuring of the nerve conduction velocity (the speed, in meters per second, at which an impulse moves along the largest fibers of a peripheral nerve.)

Image by Private individual/Wikimedia

Needle EMG of paravertebral muscles(2J009)

The needle EMG of paravertebral muscles

Image by Kychot/Wikimedia

Electromyography

Marker (white) for kinematic analysis and electrodes + preamplifiers (blue) for EMG (muscle activity) analysis.

Image by Jakarandatree/Wikimedia

Find Out Why You Hurt

Diagnosing the cause of back pain is not easy. For the majority of people with back pain, nothing is found upon physical examination or with imaging studies to clearly explain their symptoms. In fact, in about 85% of all cases, no clear reason is ever pinpointed for back pain. Conversely, imaging studies frequently find abnormalities, such as herniated discs or spondylosis, in patients who have no back pain symptoms whatsoever. It’s also possible that conditions such as degenerative disc disease may be present but may not be the cause of the pain.

Image by TheVisualMD

Find Out Why You Hurt

Diagnosing the cause of back pain is not easy. For the majority of people with back pain, nothing is found upon physical examination or with imaging studies to clearly explain their symptoms. In fact, in about 85% of all cases, no clear reason is ever pinpointed for back pain. Conversely, imaging studies frequently find abnormalities, such as herniated discs or spondylosis, in patients who have no back pain symptoms whatsoever. It’s also possible that conditions such as degenerative disc disease may be present but may not be the cause of the pain.

Image by TheVisualMD

How Is Back Pain Diagnosed?

Diagnosing Back Pain : A variety of tests can be done to try to pinpoint the causes of back pain-but it's often difficult to do so. In most cases it's not necessary for you to go to a doctor because the pain will disappear on its own, with or without treatment. But certain symptoms indicate you should seek a doctor's advice.

Image by TheVisualMD

Electromyographys comparing monkey’s control of a telerobotic arm via Joystick and brain control only.

Electromyographys comparing monkey’s control of a telerobotic arm via Joystick and brain control only.

Image by DARPA

Electromyography

D. Gordon E. Robertson

Electromyographic recording at adductor pollicis muscle and stimulation of the ulnar nerve

Paul Anthony Stewart/Wikimedia

Nerve conduction velocity (NVM) test

Private individual/Wikimedia

Needle EMG of paravertebral muscles(2J009)

Kychot/Wikimedia

Electromyography

Jakarandatree/Wikimedia

Find Out Why You Hurt

TheVisualMD

Find Out Why You Hurt

TheVisualMD

How Is Back Pain Diagnosed?

TheVisualMD

Electromyographys comparing monkey’s control of a telerobotic arm via Joystick and brain control only.

DARPA

Treatment

Sacral nerve stimulator

Image by Hellerhoff/Wikimedia

Sacral nerve stimulator

sacral neuromodulation (SNM) therapy Volume Rendering.

Image by Hellerhoff/Wikimedia

How Might Fowler's Syndrome Be Treated?

Specialists involved in the care of someone with Fowler's syndrome may include:

Gynecologist
Urologist

Source: Genetic and Rare Diseases (GARD) Information Center

Additional Materials (2)

Sacral nerve stimulator

sacral neuromodulation (SNM) therapy

Image by Hellerhoff/Wikimedia

Sacral nerve stimulator - Structure of a typical hollow fiber dialyzer

Drawing of an electrical stimulator for bladder nerves, an implanted device that delivers mild electrical pulses to the nerves that control bladder function.

Image by NIDDK

Sacral nerve stimulator

Hellerhoff/Wikimedia

Sacral nerve stimulator - Structure of a typical hollow fiber dialyzer

NIDDK

Statistics

Unknown

Image by GDJ/Pixabay

Unknown

Image by GDJ/Pixabay

How Common Is Fowler's Syndrome?

The exact number of people with Fowler's syndrome is unknown. One study estimated that Fowler's syndrome is the cause of the inability to empty the bladder in about 0.3% of cases.

Source: Genetic and Rare Diseases (GARD) Information Center

Related HealthJournals

Urinary Retention

Urinary retention can be acute or chronic. People with acute urinary retention are unable to urinate even though they have a full bladder, a potentially life-threatening medical condition. People with chronic urinary retention can urinate but can't completely empty the urine from their bladders. Learn more about both types or urinary retention.

Urinary Tract Imaging

Imaging of the urinary tract can help clarify kidney diseases, tumors, urinary tract infections (UTIs), urinary retention, small bladder capacity, and urinary reflux—the backward flow of urine. Learn about imaging techniques used to diagnose and treat urinary tract diseases and conditions. Find out what happens before, during, and after the tests.

Urine and Urination

How often you need to urinate depends on how quickly your kidneys produce the urine that fills the bladder and how much urine your bladder can comfortably hold. A healthy bladder can hold up to 16 ounces of urine for 2 to 5 hours. If this isn't the norm, read about the problems it may be attributed to.

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Fowler Syndrome

Fowler syndrome is a rare disorder in which the urethral sphincter fails to relax to allow urine to be passed normally. It mainly affects young women and can be a disabling condition. Explore symptoms, causes, and genetics of this condition.

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