Welcome to the Department of Uro-neurology information page on Fowler’s Syndrome. This website was setup in response to requests for information to be made available to patients with this condition.
There is continuous research going on into Fowler’s syndrome but apart from academic medical journals and some urological centres there is no easy way to communicate what is known about this condition to patients.
This website was setup by two research registrars at the National Hospital of Neurology and Neurosurgery Drs. Sam Datta and Rajesh Kavia, and put together by Sidhartha Datta. The aim of this website is to provide information about Fowler’s Syndrome and how to cope with the diagnosis.
Professor Clare J Fowler, MB, BS MSc FRCP is a Professor of Uro-neurology at the National Hospital of Neurology & Neurosurgery and first described the syndrome in 1985, she has continued to work on patients’ problems ever since.
She has unique first hand experience in the diagnosis and treatment of this challenging condition, but acknowledges that there is still a lot to understand.
What is Fowler’s Syndrome?
First described in 1985, it is a cause of urinary retention (inability to pass water normally) in young women. Urinary retention in young women is not common but can be quite debilitating. The abnormality lies in the urethral sphincter (the muscle that keeps you continent). The problem is caused by the sphincter’s failure to relax to allow urine to be passed normally. There is no neurological disorder associated with the condition. Up to half the women have associated polycystic ovaries.
What sort of symptoms do patients present with?
The typical woman who is seen with the condition is in her 20-30s and may infrequently pass urine with an intermittent stream. The normal sensation of urinary urgency expected with a full bladder are not present but as the bladder reaches capacity there may be pain and discomfort, and she finds that she is not able to pass urine. This can happen spontaneously or following an operative procedure (gynaecological, urological or even ENT) or following childbirth.
Classically, the woman presents to the hospital as they have been unable to pass urine for many hours and a catheter (tube that drains the bladder) is inserted, and usually over a litre is drained with consequent relief of the pain.
If the retention occurs after an operation in hospital, urinary retention may occur during the night after the operation when the patient develops pain over their bladder.
Initial hospital management is carried out by the urology team at the local hospital but if the symptoms do not resolve, the patient maybe referred on.
There is a spectrum in the severity of the condition, with some patients being able to pass urine with difficulty but leaving significant amounts, and some not being able to pass any (complete retention).
Many women who are not in complete retention, may present to they doctors complaining of recurrent cystitis (bladder infections) or even kidney infections.
What causes these symptoms?
Most of symptoms of Fowler’s Syndrome are caused by inability to empty the urine that is stored in the bladder.
Some women may experience back pain, suprapubic pain (pain over the bladder) or dysuria (discomfort/burning whilst passing urine) due the urinary infections.
The cause and process which gives rise to Fowler’s Syndrome is not known and is still under research.
How do you diagnose the condition?
The key diagnostic test for the condition is a Sphincter Electromyogram (EMG). However, this is somewhat uncomfortable since a needle must be used to record from the sphincter and needs specialist expertise and equipment. Other tests that may be carried out which indicate the diagnosis is likely include flow rate, residual volume, urethral pressure profile and ultrasound sphincter volume. These tests depend on whether you pass urine.
What are the tests? What happens? What do they tell us? Flow Rate
If you can pass urine, you sit normally as you would at home but on a special toilet that measures the speed of your stream and how long it takes you to pass urine. The computer measures the rate of flow of urine and draws a graph. We can use this to see if your stream is interrupted and how bad it is. The test is easy to perform and is totally non-invasive.
Residual Volume
This test, carried out using an ultrasound scanner, gives useful information on how well the bladder is emptying. This scan measures the amount of urine left in your bladder after you have been to the toilet. Normally, the bladder should be completely empty after passing urine.
Urodynamics
This test, sometimes also called “cystometry” is more useful if you cannot pass urine and involves placing two small catheters (tubes), one in the bladder and one in the rectum (back passage). The bladder is slowly filled with saline (salt water) and is monitored for any irregular spasms. Once, the bladder is full, you are asked to pass urine with the catheters in. This gives information on what pressure the bladder muscle generates for a particular urine flow rate.
This test takes 30-40 minutes and may cause a little discomfort on insertion of the catheters. However once the catheters are inserted, it is fairly painless.
Urethral Pressure Profile
Whilst you lie on your back, a catheter is inserted into the urethra (similar to that used in the cystometry) and saline is infused slowly through the catheter. The catheter is then withdrawn and re-inserted (six times) into the bladder whilst the pressure of the urethral sphincter is measured. This test gives information on how much pressure is generated by the sphincter, and thus how overactive the muscle is.
Ultrasound Sphincter Volume Measurement
The volume of the urethral sphincter (the muscle that keeps one continent in the normal state) is measure using ultrasound. A small probe is placed in the vagina, and the sphincter is identified. Measurements are then made and the volume calculated. It can be a little uncomfortable on insertion of the probe, but once the sphincter is found, most patients do not find it too bothersome. An overactive sphincter may enlarge due to continuous ‘muscle activity’.
Sphincter Electromyogram (EMG)
This is the gold standard test for Fowler’s syndrome, and is done to confirm our other findings. Professor Fowler usually performs this test within the department.
With the patient lying on their back, local anaesthetic is injected into the sphincter region. A small needle is then used to take recordings from the sphincter. The area from which the needle takes the recording is very small (1mm³). (It is quite a complex and tricky test sometimes).
Characteristic waveforms and sounds can be identified using this technique. The abnormality in Fowler’s syndrome is a complex repetitive discharge and decelerating bursts, but to the non specialist, it is the sound of ‘helicopters’ and ‘whales’.
Audio Clip 1 – Example of complex repetitive discharges Audio Clip 2 – Complex repetitive discharges + Decelerating Bursts (Sounds like underwater whales) Audio Clip 3 – More Complex Discharges with background of decelerating Bursts Audio Clip 4 – Clearer Decelerating Bursts What happens to me once the diagnosis is made?
Fowler’s syndrome is a condition which is slowly being understood. There is no absolute cure for the condition yet. The aim of treatment is to try and ensure bladder emptying.
Bladder function may spontaneously recover in some patients, especially in the group in whom the problems started after childbirth.
In patients with little recovery, it can be a lifelong condition which can cause significant impact to quality of life.
At the National Hospital, we have a specialist team of doctors, nurses and continence advisors to help manage your condition long term. There are various treatments that are used to regain control and overcome the symptoms.
Are there any treatments?
Currently the treatments for Fowler’s syndrome are being researched and developed. Depending on the severity of the condition, there are various but limited options.
Often patients have a poor urine stream but can still void almost normally. In these patients, we monitor their residual volume. If they are low, no intervention is necessary.
Some patients have a large residual volume which gives rise to urinary infections and a large bladder. These patients are helped by regular clean intermittent catherisation (putting a sterile catheter into the bladder at regular intervals to empty the bladder).
The most severe patients, those in complete retention may be candidates for sacral nerve stimulation, which is the only treatment shown to restore voiding. However this requires major efforts by the patient, is expensive, often troubled by operative difficulties and cannot be regarded as a "good fix".
What is intermittent self catheterisation?
This is where you as the patient will insert a catheter (tube) into your bladder to empty it. This is done at regular intervals to ensure there is not a stagnant volume of urine, which can give rise to infections. Our continence advisors can teach this technique, and suggest ways to make it as easy as possible. They also can help arrange to put you in contact with suppliers of the most suitable catheters for your convenience.
The procedure is not too uncomfortable, however many women do complain that although it is easy to insert the catheter, removal is painful and that the catheter gets ‘stuck’ when attempting to withdraw it.
What is Sacral Nerve Stimulation?
Sacral nerve stimulation (SNS) is a process whereby small electrical pulses stimulate nerves in the lower back (just above the tail bone [sacrum]). The nerves stimulated are those involved in control of bladder sensation. How the stimulation works at restoring voiding is still under research.
If you are deemed eligible for SNS, then the first stage is to test stimulation, peripheral nerve evaluation (PNE). A temporary lead is inserted into the 3rd sacral foramen (naturally occurring hole in the lower spine) using an external stimulator (looks similar to pager) and the response is assessed for 3 to 7 days. You will need to keep a diary to record your symptoms. In approximately two thirds of the women there will be a restoration of voiding.
If bladder function is improved then the patient will be placed on the waiting list for a staged SNS implant. The implant is the InterStim Therapy® produced by Medtronic® (more information about the InterStim implant is available at www.medtronic.com).
The staged operation involves the placement of a permanent electrode (see right), either under local or general anaesthetic. This is connected to an external stimulator source and the response assessed for 4 weeks. If the lead placement results in good voiding with minimal side effects then the stimulator is internalised. It is thought that this second longer period of test stimulation with the permanent lead should reduce the future complications and improve success rates. The stimulator is usually placed in the buttock or abdomen.
Why may I not be considered for SNS?
If you live a great distance form the National Hospital or you find the journey to the hospital difficult then we may not consider you for the treatment, as on average you would be required to be seen at the hospital four times a year.
You may not be considered for SNS if the test stimulation is unsuccessful.
What options have I got if SNS is not possible and I cannot self catheterise?
If you are unable to catheterise and SNS is not an option, then a long term catheter may be required. This may be a permanent tube that drains your bladder either via your urethra or via a suprapubic catheter (a tube placed below you belly button, into your bladder). For more information see attached article.
Very occasionally, if you are in complete retention you may be offered more radical procedures, such as removal of the bladder (these may sound attractive but are not short of complications or suitable for all).
This technique has showed some good results with many not needing to catheterise. However it is not always easy to get a good result and some patients have found over time that they have run into problems with batteries needing replacement, reduced effect and needing to catheterise or pain down the leg.
Who can I see for help? General Practitioner – will be able to advise or refer patients. Continence Adviser – teach clean self intermittent catherisation techniques, advice on catheters, moral support. Consultant Urologist – local urologist may have experience on Fowler’s Syndrome may refer on to Specialist unit such as National Hospital. National Hospital for Neurology & Neurosurgery – referral for diagnosis and help with management can be obtained here. Web Links
女儿是高中十二年级学生。去年圣诞夜前一天下午突然说小便没办法解，当天努力很久，解出来了。第二天圣诞夜，上午好好的，下午三点到五点一直解不了，六点只好去急诊。晚上八点多用了导尿管，500毫升。12/27早上去泌尿科拔掉导尿管。医生几乎什么都没说，只说年轻女孩极少有问题，stress也不会引起这种问题。
我不放心，去中医那里针灸，吃汤药。没想到这个我信任的中医（国内正宗针灸所出来的）这次太自以为是，用的都是清火通淋的药。第一次停药十天又发生，然后第二次停药七天又来。开始每次都是下午三五点发生，后来发展到早上就觉得困难。第三次药没吃完，女儿说感觉越来越不好。这时候我在网上查到中医对这种症状的不同情况分析，结合她多年来的表现，我估计是肾阳虚引起的。 赶紧换中医。
这个中医是内科出生， 以前给女儿看过咳嗽，拉肚子之类的病。 现在回想，她的拉肚子根本就是五更泻，而不是普通的脾虚。 这位医生以前也没想到，主要觉得小孩不太可能发生肾阳虚。
总结一下女儿的综合情况：
1. 长得快，5，6年级就长完身高。 膝盖，骨骼转动时都容易响，牙根短，这些一直有。
2. 七年级开始，花粉过敏橡树开花季节会激发哮喘，脱敏针剂量上不去（会有过敏反应），所以没用。在室内不出去最管用，药都不需要。
3. 九，十年级开始，早起就会拉肚子。周末睡懒觉就不会。 近半年发展到睡懒觉也会莫名其妙拉肚子。
4. 耳朵一直怕太响的声音。没有耳鸣。
5. 经常感冒。因为我给她秋冬喝点黄芪枸杞水，小学后很少得流感。就是会common cold。 15年时，喝点玉屏风冲剂就有用，去年春天开始，玉屏风也没用。
6. 夜尿越来越多。本来我就觉得小孩晚上不应该超过一次的。 去年发病前，发展到三次。
7. 12/23 当天发病的早上， 我发现她头顶偏右一点，突然出现硬币大小面积的一撮全白头发，在发根。
8. 以前偶尔长痘痘。12月额头爆发，而且是那种发不出来的痘痘。
9. 在过去的这个冬天特别怕冷，晚上比往年都盖得多。白天手脚冰凉。
经过中医两个半月的补肾阳治疗， 基本没有发生过小便解不出。期间吃过几次鹿茸，一吃，额头上的痘痘就瘪掉，里面的脂肪粒（好硬,象石头）就掉出来。
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我想问的是，为什么女儿那么年轻会肾阳虚？我觉得自己很失败是因为我崇尚自己做饭，从新鲜的做起。我家很少process food。没有方便面，没有速冻饺子。 从小就注意营养均衡。女儿荤素都吃，不偏食。 她因为脑子好，学习很轻松，每晚十点睡觉，在70%亚裔的学校，名列第一。我不是推妈，从不强迫她做她不喜欢的课外活动。我查了， 除了缺锌不确定， stress就算有，也不会很大。实在不懂。 不过她是喜静的孩子，运动比较少。
另外一个问题是，她现在还是非常怕冷，一冷（比方说去Costco），就频繁想上厕所 （夜尿现在2次，有时第二次已经早上六点多）。不知道是不是一直没有补血有关（医生怕她脾胃虚，不敢补血）。上周的药有点补血了。 她的白发没有好转，还在缓慢增多，右侧冒出来零星的7，8 根，不是刚开始集中一块。
我现在最头痛的问题是，这个病在心理上的影响是巨大的。小便慢一点，她就会紧张。吃了补阳药后，发生过几次假性的尿不出来。比方说有event，在外校考AP。每次都是一回家就好了 （12月发病时，放寒假在家，怎么都尿不出，泡脚，热水澡都不行，和现在完全不同）。她自己的感觉是有好转，但没那么好，所以紧张会有影响。可是我很担心以后变成心理疾病，一直这样就麻烦了。 她会在local上大学，但开车过去要一个小时。 参观学校那天，她就没去成。开到半路，她要上厕所，其实离家只有半小时。尿不出来就不敢去。回家马上就尿出来了。 其实我知道她是担心。生怕到那里尿不出来，再回家泡脚，洗热水澡，时间就太久了。其实真正尿不出已经没有发生，她就是有心理阴影。 我该怎么办？ 有点心焦。
她这种情况要补多久？这种假性的到底是心理因素还是象她自己说的还不够力？
谢谢！
🔥 最新回帖
如果看过泌尿科医生了，但没有找到原因，请去看肾科医生，如果孩子小于18岁，请去看小儿肾科医生。
医生会查24小时尿，会查尿蛋白。
如果你孩子以前得过很多次感冒，有可能因为感冒而引起小儿隐匿性肾炎。
这种肾炎之所以叫隐匿性肾炎，是因为症状不明显，医生常常漏诊。
千万别给孩子乱吃药，要用食疗的方法。
食疗方：一把赤小豆，一把薏仁，一只鹌鹑，半茶匙料酒，一小片姜，加三碗水，隔水炖熟炖烂，炖好后加一点盐。
大概要炖两个小时以上，分两天吃完。
一定要坚持吃一段时间，起码要三个月到半年，就当喝鸡汤了。
因为有朋友家的孩子有这样相似的症状，他们家的孩子现在已经完全康复了。
楼主请一定带你的孩子去看肾科医生。
希望我的这些话对你有所帮助，希望你的孩子安好。
🛋️ 沙发板凳
尿常规两次，X 光， B超，一切正常。
如果泌尿外科通过检查，没有发现任何器质性疾患，再由泌尿外科推荐转其他专科。。。看病要遵从逻辑，一步一步地排除和缩小范围，特别是对于非典型的病例。要走程序，不期望大师。程序走完了，问题就水落石出了。
挺佩服你的中医素养的，自己还能对症下药，她是你亲生闺女吗？是自己亲生的娃怎么能自作主张长期灌药呢？
转帖：
Fowler's Syndrome Introduction
Welcome to the Department of Uro-neurology information page on Fowler’s Syndrome. This website was setup in response to requests for information to be made available to patients with this condition.
There is continuous research going on into Fowler’s syndrome but apart from academic medical journals and some urological centres there is no easy way to communicate what is known about this condition to patients.
This website was setup by two research registrars at the National Hospital of Neurology and Neurosurgery Drs. Sam Datta and Rajesh Kavia, and put together by Sidhartha Datta. The aim of this website is to provide information about Fowler’s Syndrome and how to cope with the diagnosis.
Professor Clare J Fowler, MB, BS MSc FRCP is a Professor of Uro-neurology at the National Hospital of Neurology & Neurosurgery and first described the syndrome in 1985, she has continued to work on patients’ problems ever since.
She has unique first hand experience in the diagnosis and treatment of this challenging condition, but acknowledges that there is still a lot to understand.
What is Fowler’s Syndrome?First described in 1985, it is a cause of urinary retention (inability to pass water normally) in young women. Urinary retention in young women is not common but can be quite debilitating. The abnormality lies in the urethral sphincter (the muscle that keeps you continent). The problem is caused by the sphincter’s failure to relax to allow urine to be passed normally. There is no neurological disorder associated with the condition. Up to half the women have associated polycystic ovaries.
What sort of symptoms do patients present with?The typical woman who is seen with the condition is in her 20-30s and may infrequently pass urine with an intermittent stream. The normal sensation of urinary urgency expected with a full bladder are not present but as the bladder reaches capacity there may be pain and discomfort, and she finds that she is not able to pass urine. This can happen spontaneously or following an operative procedure (gynaecological, urological or even ENT) or following childbirth.
Classically, the woman presents to the hospital as they have been unable to pass urine for many hours and a catheter (tube that drains the bladder) is inserted, and usually over a litre is drained with consequent relief of the pain.
If the retention occurs after an operation in hospital, urinary retention may occur during the night after the operation when the patient develops pain over their bladder.
Initial hospital management is carried out by the urology team at the local hospital but if the symptoms do not resolve, the patient maybe referred on.
There is a spectrum in the severity of the condition, with some patients being able to pass urine with difficulty but leaving significant amounts, and some not being able to pass any (complete retention).
Many women who are not in complete retention, may present to they doctors complaining of recurrent cystitis (bladder infections) or even kidney infections.
What causes these symptoms?Most of symptoms of Fowler’s Syndrome are caused by inability to empty the urine that is stored in the bladder.
Some women may experience back pain, suprapubic pain (pain over the bladder) or dysuria (discomfort/burning whilst passing urine) due the urinary infections.
The cause and process which gives rise to Fowler’s Syndrome is not known and is still under research.
How do you diagnose the condition?The key diagnostic test for the condition is a Sphincter Electromyogram (EMG). However, this is somewhat uncomfortable since a needle must be used to record from the sphincter and needs specialist expertise and equipment. Other tests that may be carried out which indicate the diagnosis is likely include flow rate, residual volume, urethral pressure profile and ultrasound sphincter volume. These tests depend on whether you pass urine.
What are the tests? What happens? What do they tell us? Flow RateIf you can pass urine, you sit normally as you would at home but on a special toilet that measures the speed of your stream and how long it takes you to pass urine. The computer measures the rate of flow of urine and draws a graph. We can use this to see if your stream is interrupted and how bad it is. The test is easy to perform and is totally non-invasive.
Residual VolumeThis test, carried out using an ultrasound scanner, gives useful information on how well the bladder is emptying. This scan measures the amount of urine left in your bladder after you have been to the toilet. Normally, the bladder should be completely empty after passing urine.
UrodynamicsThis test, sometimes also called “cystometry” is more useful if you cannot pass urine and involves placing two small catheters (tubes), one in the bladder and one in the rectum (back passage). The bladder is slowly filled with saline (salt water) and is monitored for any irregular spasms. Once, the bladder is full, you are asked to pass urine with the catheters in. This gives information on what pressure the bladder muscle generates for a particular urine flow rate.
This test takes 30-40 minutes and may cause a little discomfort on insertion of the catheters. However once the catheters are inserted, it is fairly painless.
Urethral Pressure ProfileWhilst you lie on your back, a catheter is inserted into the urethra (similar to that used in the cystometry) and saline is infused slowly through the catheter. The catheter is then withdrawn and re-inserted (six times) into the bladder whilst the pressure of the urethral sphincter is measured. This test gives information on how much pressure is generated by the sphincter, and thus how overactive the muscle is.
Ultrasound Sphincter Volume MeasurementThe volume of the urethral sphincter (the muscle that keeps one continent in the normal state) is measure using ultrasound. A small probe is placed in the vagina, and the sphincter is identified. Measurements are then made and the volume calculated. It can be a little uncomfortable on insertion of the probe, but once the sphincter is found, most patients do not find it too bothersome. An overactive sphincter may enlarge due to continuous ‘muscle activity’.
Sphincter Electromyogram (EMG)This is the gold standard test for Fowler’s syndrome, and is done to confirm our other findings. Professor Fowler usually performs this test within the department.
With the patient lying on their back, local anaesthetic is injected into the sphincter region. A small needle is then used to take recordings from the sphincter. The area from which the needle takes the recording is very small (1mm³). (It is quite a complex and tricky test sometimes).
Characteristic waveforms and sounds can be identified using this technique. The abnormality in Fowler’s syndrome is a complex repetitive discharge and decelerating bursts, but to the non specialist, it is the sound of ‘helicopters’ and ‘whales’.
Audio Clip 1 – Example of complex repetitive discharges Audio Clip 2 – Complex repetitive discharges + Decelerating Bursts (Sounds like underwater whales) Audio Clip 3 – More Complex Discharges with background of decelerating Bursts Audio Clip 4 – Clearer Decelerating Bursts What happens to me once the diagnosis is made?Fowler’s syndrome is a condition which is slowly being understood. There is no absolute cure for the condition yet. The aim of treatment is to try and ensure bladder emptying.
Bladder function may spontaneously recover in some patients, especially in the group in whom the problems started after childbirth.
In patients with little recovery, it can be a lifelong condition which can cause significant impact to quality of life.
At the National Hospital, we have a specialist team of doctors, nurses and continence advisors to help manage your condition long term. There are various treatments that are used to regain control and overcome the symptoms.
Are there any treatments?Currently the treatments for Fowler’s syndrome are being researched and developed. Depending on the severity of the condition, there are various but limited options.
Often patients have a poor urine stream but can still void almost normally. In these patients, we monitor their residual volume. If they are low, no intervention is necessary.
Some patients have a large residual volume which gives rise to urinary infections and a large bladder. These patients are helped by regular clean intermittent catherisation (putting a sterile catheter into the bladder at regular intervals to empty the bladder).
The most severe patients, those in complete retention may be candidates for sacral nerve stimulation, which is the only treatment shown to restore voiding. However this requires major efforts by the patient, is expensive, often troubled by operative difficulties and cannot be regarded as a "good fix".
What is intermittent self catheterisation?This is where you as the patient will insert a catheter (tube) into your bladder to empty it. This is done at regular intervals to ensure there is not a stagnant volume of urine, which can give rise to infections. Our continence advisors can teach this technique, and suggest ways to make it as easy as possible. They also can help arrange to put you in contact with suppliers of the most suitable catheters for your convenience.
The procedure is not too uncomfortable, however many women do complain that although it is easy to insert the catheter, removal is painful and that the catheter gets ‘stuck’ when attempting to withdraw it.
What is Sacral Nerve Stimulation?Sacral nerve stimulation (SNS) is a process whereby small electrical pulses stimulate nerves in the lower back (just above the tail bone [sacrum]). The nerves stimulated are those involved in control of bladder sensation. How the stimulation works at restoring voiding is still under research.
If you are deemed eligible for SNS, then the first stage is to test stimulation, peripheral nerve evaluation (PNE). A temporary lead is inserted into the 3rd sacral foramen (naturally occurring hole in the lower spine) using an external stimulator (looks similar to pager) and the response is assessed for 3 to 7 days. You will need to keep a diary to record your symptoms. In approximately two thirds of the women there will be a restoration of voiding.
If bladder function is improved then the patient will be placed on the waiting list for a staged SNS implant. The implant is the InterStim Therapy® produced by Medtronic® (more information about the InterStim implant is available at www.medtronic.com).
The staged operation involves the placement of a permanent electrode (see right), either under local or general anaesthetic. This is connected to an external stimulator source and the response assessed for 4 weeks. If the lead placement results in good voiding with minimal side effects then the stimulator is internalised. It is thought that this second longer period of test stimulation with the permanent lead should reduce the future complications and improve success rates. The stimulator is usually placed in the buttock or abdomen.
Why may I not be considered for SNS?If you live a great distance form the National Hospital or you find the journey to the hospital difficult then we may not consider you for the treatment, as on average you would be required to be seen at the hospital four times a year.
You may not be considered for SNS if the test stimulation is unsuccessful.
What options have I got if SNS is not possible and I cannot self catheterise?If you are unable to catheterise and SNS is not an option, then a long term catheter may be required. This may be a permanent tube that drains your bladder either via your urethra or via a suprapubic catheter (a tube placed below you belly button, into your bladder). For more information see attached article.
Very occasionally, if you are in complete retention you may be offered more radical procedures, such as removal of the bladder (these may sound attractive but are not short of complications or suitable for all).
This technique has showed some good results with many not needing to catheterise. However it is not always easy to get a good result and some patients have found over time that they have run into problems with batteries needing replacement, reduced effect and needing to catheterise or pain down the leg.
Who can I see for help? General Practitioner – will be able to advise or refer patients. Continence Adviser – teach clean self intermittent catherisation techniques, advice on catheters, moral support. Consultant Urologist – local urologist may have experience on Fowler’s Syndrome may refer on to Specialist unit such as National Hospital. National Hospital for Neurology & Neurosurgery – referral for diagnosis and help with management can be obtained here. Web LinksFowler's Syndrome website - http://www.fowlersyndrome.co.uk/
Fowler’s Forum – Link to patient’s only forum on fowler’s syndrome.
http://www.greenspun.com/bboard/q-and-a-fetch-msg.tcl?msg_id=00AO8l
Web Link to Medtronic site
http://www.medtronic.com
Web link to Bladder and Bowel Foundation
http://www.bladderandbowelfoundation.org
We are not responsible for content on any external internet sites.
invasive test。导尿管已经把她吓到了。除了梗阻性的，就是神经性的。我高中同学就是泌尿科医生，从业30年了。神经性的要么先天，要么有事故手术发生。 她什么都没有。 神经性的西医根本无能为力，知道有什么用。 所以X光和B超排除结石后就没继续查了。另，她没有尿不干净或间歇尿的症状。
谢谢
注意到你女儿过敏和哮喘。她有吃抗过敏药如claritin或Zrytecm吗？或其它什么抗组胺的？吃过多久？
这种焦虑可能传染给了你的女儿。
这种身体不能太累。估计得吃些牛肉汤之类的，少吃寒凉的东西，多吃多晒太阳，运动强度从低开始慢慢加，运动量1下太大她这身体承受不了。不知她是从小天生体质就弱，还是后来日积月累导致？ 现在饮食饱足，这个年龄，身体不应这样（类似情况在长期节食减肥的女孩中才能见到），这种不能单指望药物，得从日常生活起居做起，一步步来慢慢养，快不了。
仅是从这贴中这点信息得来的印象，具体的得看医生诊断。
我和我妈身体都弱，而且都属于肾气不足。女儿小学四年级时，一年五次流感，每次伴随高烧。九月开学后，莫名心动过速。进过急诊，看过心脏科大夫，无解。后吃中药三个月，活蹦乱跳。以后每年秋冬吃12克黄芪。就此只得过两次流感，而且症状轻微。
过敏测试对四季所有植物过敏。没有食物过敏问题。虽然不是四季都吃Zyrtec，但吃的不少。
感谢提醒！
我和我妈都弱。女儿四年级时一年五次流感。暑假后开始莫名其妙心动过速。进过急诊，看过心脏专科，完全无解，没任何问题。后吃中药三月，又活蹦乱跳。中医说五次流感，次次高烧，伤到了。后来每年秋冬吃12克黄芪，到今年一共只有两次很轻微的流感。
怕搞出心理疾病。再说，神经性西医根本无解啊。
肉桂，肉豆蔻，山茱萸，山药之类。全是补药。那么热的药，也不上火。
老母鸡炖黄芪党参下面条。
后来图省事就用六味地黄丸代替，连吃3天。
息，甚至休学一年，调整心情。说实话，她这个成绩没啥大不了的，当年那么多状元现在又都在哪里？真正上班了就知道，尤其是投行啊，Google啊之类，最后升上去的都是身体壮，扛得住的，能跑个马拉松啥的。脑子再聪明，除非是爱因斯坦，牛顿再世，没啥大区别
抗组织胺类作用的药都可能引起尿储留。我有病人用有抗组织胺副作用的药类，也有尿储留的问题。通过暂停几天，以后低剂量用，不那么频繁地用这类药，这种尿储留现象就没了。
最好咨询一下她的医生，看看她的医生有啥意见。
其实肾阳虚未必会引起尿潴留。可能阳虚加上过敏药，容易发生这种症状吧。
这是她问题所在！ Zyrtec 造成microcirculation problem， 收缩毛细血管。。。我观察到各个对微循环敏感组织出问题的病例，包括眼睛，肾，脑。。。所有检查找不出原因，但都有长期服用Zyrtec的历史的中年人和你女儿这么年轻的小青年。这也可以解释中药补肾补血有帮助。非常可怕的OTC药，竟然没有warning。赶紧停服。
我回国那年用刮痧板刮他腰部及臀部，结果他腰部疼痛难忍，不让我刮。他妈妈也是个半吊子中医爱好者，懂一点中医、但不多。她用拔罐狠狠的吸住她儿子腰部，拔出很黑很黑的淤斑。把我吓了一大跳，用力那么狠，担心出问题。结果当天晚上就能自己起床上厕所了，再也没有尿床了。 中医很好，可惜能为你解决问题的好中医不多。
没什么效果，后来去附近街道医院看了个中医门诊，医生搭脉，也说什么很虚，配了一瓶健脾丸？具体我也忘了，能记住的就是一瓶药没吃完，我就好了
http://old.tua.org.tw/magazine/FileM/dw2005121104536_%E7%95%A2%E6%9F%B3%E9%B6%AF%E5%A9%A6%E6%B3%8C4-1.pdf
找不对医生，往往会被庸医误事。但不等于中医不好。
查过两次尿，间隔一个半月。第一次就是在急诊做的。没有一个指标不正常。
明天体检，我会要求血检肾功能。
我一好朋友，信中医，自然很看不上西医。每天给孩子吃什么要按照八卦为依据，每天给孩子在身上各个穴位贴胶布和那个神奇的小豆子，如果孩子有任何不适和行为上的麻烦，第一反应就是今天穴位贴错了，吃的东西不合八卦，喝了一口冷水，我是感觉孩子迟早被他吓得半死，而且不停地被暗示：我不如别人，我必须喝热水，我必须贴胶布，否则今天一定有麻烦。孩子可怜吧？
怕冷是内分泌失调的重要症状。
free T3 在2.6， 正常值2.3-4.2. TSH， free T4 都在中间。
额头上应该是封闭型粉刺，有些卸妆油，或是油份太重的护肤品会引起封闭型粉刺的。不要用刺激性的润肤品，早晚用Aveeno Ultra-Calming foaming cleaner 洗脸，然后用Sisley 的 Emulsion Ecologique 护肤，慢慢粉刺就消失了。有了封闭性粉刺，不要用手挤，这样会越挤越多。去买一根粉刺针（日本化妆品，杂货店有卖，有些香港人开的小礼品店也有售），用粉刺针的另外一头有一个小铁圈的那头去把粉刺压出来，这样粉刺就不会再长回来。祝楼主和女儿平安幸福！
其实 仔细想想，这是一种暗示疗法，
我也是过来人。理解你。西医是根本，从头查到脚，不要轻易放弃。中药在于调理。相信你的中药知识。我不多说了。热药里没有附子，为什么？热药首推附子呀。另外试下食疗如何？要人发热，吃大蒜，蒜泥敷脚心试试，小心点，少量试，注意观察。广东人坐月子吃八珍甜醋炖猪脚，补肾气，一天二个，试一个月看看。不要沮丧，不要忧郁。慢慢会好起来的。不是安慰你，是真的，这是命运，过几年就会变的。good luck.
就是那天拔了一次后，再也没尿到床上了。