Chronic idiopathic urinary retention and Fowler's syndrome in women: A multidisciplinary framework for assessment and nonsurgical management
Abstract Chronic idiopathic urinary retention and Fowler's syndrome are a debilitating problem primarily affecting women, characterised by an inability to urinate in the absence of any identifiable structural or other cause. An increasingly wide range of multifactorial predisposing, precipitating, and perpetuating biopsychosocial factors are being recognised. This has led to interest in nonsurgical treatments that may complement existing surgical approaches. We reviewed existing literature on nonsurgical management and combined this information with collective multidisciplinary professional and lived experience, to produce a new definition of chronic idiopathic urinary retention (the Fife Definition) and a framework for the assessment and nonsurgical treatment for women with chronic idiopathic urinary retention. The article provides a stepped care approach to nonsurgical treatment including explanation and formulation, basic bladder healthcare, optimising catheterisation, management of relevant comorbidities, multidisciplinary treatment and additional treatment options and emerging therapies.
Authors
- Collete Haslam
- Carolyn Davie
- Claire Hentzen (ORCID: https://orcid.org/0000-0002-9223-4925)
- Jon Stone (ORCID: https://orcid.org/0000-0001-9829-8092)
- Emily Jay
- Ingrid Hoeritzauer (ORCID: https://orcid.org/0000-0001-6742-7197)
- H. Simpson
- Sarah McRae
- Alan Carson (ORCID: https://orcid.org/0009-0001-3647-1686)
- Jalesh N. Panicker (ORCID: https://orcid.org/0000-0001-5190-3259)
- Natalia Vásquez
- Helen Jinadu
- Glenn Nielsen (ORCID: https://orcid.org/0000-0001-6053-5670)
- Miriam Gamble
- Laura McWhirter (ORCID: https://orcid.org/0000-0001-9839-6549)
- Caoimhe McLoughlin (ORCID: https://orcid.org/0000-0001-8159-1516)
- Leila Heelas (ORCID: https://orcid.org/0000-0003-4878-5751)
- Clare Nicholson
- Caroline Selai
- Mahreen Pakzad
- Dani Coombe
- Anne Sanderson
- Claire Todd (ORCID: https://orcid.org/0000-0003-2750-3006)
- Victoria Hulman
- Martine Cornillet
- Beatrice Garcin
- Louise Young
- Sioned Hancock
- Voula Granitsiosis
Institutions
- NHS Lothian (GB)
- King's College London (GB)
- South London and Maudsley NHS Foundation Trust (GB)
- NHS Tayside (GB)
- NHS Fife (GB)
- Sorbonne Université (FR)
- European Institute of Women's Health (IE)
- St George's Hospital (GB)
- Pitié-Salpêtrière Hospital (FR)
- Hôpital Avicenne (FR)
- Oxford University Hospitals NHS Trust (GB)
- Synome (United Kingdom) (GB)
- University College London (GB)
- University of Edinburgh (GB)
Publication Details
- Journal
- BJUI Compass
- Published
- 2026-07-01
- DOI
- https://doi.org/10.1002/bco2.70240
- Primary Topic
- Urinary Tract Infections Management
- Type
- article
- Field-Weighted Citation Impact
- 0.00