04 Association with Polycystic Ovary (PCO)

At the time of the original description of Fowler’s Syndrome in 1988 (Fowler, Christmas et al. 1988) many of the patients were observed to be hirsute, obese and to have menstrual irregularities and there appeared to be a clinical association with polycystic ovaries (PCO).  This association is now no better understood than when the observation was first made, and although the co-incidence of PCO and retention is by no means inevitable, a hormonal basis for the EMG abnormality seems likely (see section “What has gone wrong”) The same type of sphincter disorder has not been found in men with otherwise unexplained retention. According to recent work by O’Connell and her colleagues the distal urethra is a constituent part of the clitoris, forming the “clitoro-urethrovaginal complex” (O’Connell and DeLancey 2005) and hence clearly the distal urethra has major sex determined attributes.