Trachta Jan, Wachter Johann, Kriz Jan
Department of Paediatric Surgery and Urology, Motol University Hospital, Charles University in Prague, Prague, Czech Republic.
Department of Urology, Kaiser-Franz-Josef Spital, Wien, Austria.
European J Pediatr Surg Rep. 2018 Jan;6(1):e77-e80. doi: 10.1055/s-0038-1672147. Epub 2018 Oct 18.
Fowler's syndrome (FS) is a rare cause of chronic urinary retention in teenage girls and young women. We present a case of a 14-year-old girl who presented at our hospital 2 weeks after uncomplicated laparoscopic appendectomy. The girl complained of reduced urinary frequency and prolonged micturition time. Following an acute cystitis 2 months later, she completely lost her ability to void. A comprehensive set of investigations to assess the cause of her urinary retention including a cerebral and spinal magnetic resonance imaging (MRI), and videourodynamics were performed. The diagnostic workup revealed polycystic ovaries and an asensitive and hypotonic bladder with capacity up to 1200 mL and high maximum urethral pressure of 120 cm of water. She did not tolerate clean intermittent catheterization; therefore, a suprapubic catheter was placed. Under this treatment, she suffered recurrent urinary tract infections. Two years later, she was diagnosed with FS on the basis of the medical history, clinical symptoms, and urodynamic findings. Finally, the implantation of a S3 neurostimulator restored her ability to void.
福勒综合征(FS)是少女和年轻女性慢性尿潴留的罕见病因。我们报告一例14岁女孩的病例,她在无并发症的腹腔镜阑尾切除术后2周来我院就诊。该女孩主诉尿频减少和排尿时间延长。2个月后发生急性膀胱炎,她完全丧失了排尿能力。进行了一系列全面检查以评估其尿潴留的原因,包括脑部和脊髓磁共振成像(MRI)以及尿动力学检查。诊断性检查发现多囊卵巢,膀胱感觉迟钝且低张,容量达1200 mL,最大尿道压高达120 cm水柱。她无法耐受清洁间歇性导尿;因此,放置了耻骨上导管。在此治疗下,她反复发生尿路感染。两年后,根据病史、临床症状和尿动力学检查结果,她被诊断为FS。最后,植入S3神经刺激器恢复了她的排尿能力。