Khan A T, Kinder R B, Hayman R G
Department of Obstetrics and Gynaecology, Cheltenham General Hospital, Cheltenham, UK.
BMJ Case Rep. 2010 Sep 9;2010:bcr0520103032. doi: 10.1136/bcr.05.2010.3032.
We present a favourable outcome of a pregnant woman with underlying Fowler's syndrome. This is a rare disorder affecting young women with painless urinary retention, and as there is no known cure, the main concern is to ensure adequate bladder emptying. Our patient went through self-catheterisation and suprapubic catheters after which she was finally successfully managed on a sacral nerve stimulator (SNS). Upon getting pregnant the stimulator was switched off due to safety concerns, and from then on, bladder emptying was managed with a suprapubic catheter (which was regularly changed over the gestation). The main concern thereafter was recurrent hospital admissions with urinary tract infections and pelvic pain requiring parenteral antibiotics and analgesia. She underwent an uncomplicated elective caesarean section at 36 weeks and delivered a healthy female infant. The SNS was successfully reactivated in the postnatal phase, and the suprapubic catheter was removed upon achieving adequate urethral output.
我们报告了一例患有潜在福勒综合征的孕妇的良好预后情况。福勒综合征是一种罕见的疾病,影响年轻女性,导致无痛性尿潴留,由于尚无已知的治愈方法,主要关注点是确保膀胱充分排空。我们的患者经历了自我导尿和耻骨上导尿,最终通过骶神经刺激器(SNS)成功得到治疗。怀孕后,出于安全考虑关闭了刺激器,从那时起,通过耻骨上导尿管进行膀胱排空管理(在整个孕期定期更换)。此后主要的问题是因尿路感染和盆腔疼痛反复住院,需要胃肠外使用抗生素和镇痛剂。她在36周时顺利进行了择期剖宫产,产下一名健康的女婴。产后阶段成功重新激活了骶神经刺激器,在尿道排尿量充足后拔除了耻骨上导尿管。