Does the presence of Fowler's syndrome predicts successful long-term outcome of sacral nerve stimulation in women with non-obstructive urinary retention?

Background: Fowler's syndrome (FS) is a rare disorder in which the urethral sphincter fails to relax to allow urine to be passed normally. Methods: A Forty-two (17- to 61-year-old) suffering from refractory NOUR had successful first stage SNM with Interstim II device, in whom second stage complemented were studied prospectively in department of neurogenic bladder and neuromodulation in our hospital, from February 2016 to February 2023 regarding efficacy and safety of SNM. Key Findings: Forty-two women with a history of fowler syndrome. Their mean age was 27.2 ± 12.4 years. The success rate of responder patients was 79 % (30/38), their mean pre operative PVR was 332 ± 83 mls, had been fallen to 80 ± 49 mls after stimulation (P 0.001), with significant mean difference of 252. The mean voided volumes per day was 61 ± 24.5 mls became 302 ± 75 (P 0.001), and the mean difference (241) was significant too. The total No. of patients who required surgical revision of their devices were 10 (26.4 %), malfunction due to external trauma in four (10.5 %), continuous pain and discomfort at lead or IPG sites that didn't respond to reprogramming in four ((10.5 %), device infection in two (5 %). Conclusion: SNM is FDA approved effective and safe minimally invasive therapy for women with Fowler's syndrome.