Malik Humaira S, Saad Salma
Department of Obstetrics and Gynecology, Dumfries and Galloway Royal Infirmary, Dumfries, GBR.
Cureus. 2025 Aug 5;17(8):e89423. doi: 10.7759/cureus.89423. eCollection 2025 Aug.
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.
福勒氏综合征因尿道括约肌无法松弛而导致尿潴留。治疗目标是实现膀胱完全排空,通常通过间歇性自我导尿来完成。如果保守治疗失败,对于伴有福勒氏综合征的逼尿肌过度活动,可通过行膀胱扩大术和米氏术进行手术治疗,以增加膀胱容量并降低压力。我们报告了一例罕见病例,一名患有福勒氏综合征和逼尿肌过度活动的女性怀孕,她此前接受过膀胱扩大术和米氏术。她有一个可控的、用于清洁间歇性导尿的功能性腹部造口。她的孕期因反复尿路感染和膀胱痉挛而复杂化,需要使用抗生素。在给予类固醇并与多学科团队讨论后,于35周时进行了计划剖宫产,产下一名活婴。该病例说明了这些女性孕期管理的复杂性,强调了个体化多学科护理的必要性。