A 30-year-old woman with a rare condition that left her looking nine months pregnant has not been able to urinate for two-and-a-half years. Evan Francis, from the Isle of Sheppey, who works in PR, spent six months in agony before being diagnosed with Fowler's syndrome in July 2024 - a condition that stops the bladder from emptying.
Her symptoms began around Christmas 2023, when she had days when she could not urinate. She became so bloated that she looked pregnant, and medics eventually drained a litre of urine from her bladder.
Diagnosis and early struggles
Evan went to her GP on January 3, 2024, with back pain and bloating and was given antibiotics for a urinary tract infection. Two weeks later she returned with the same symptoms and told them she had not urinated in two days; she was told it was another UTI.
An ultrasound in mid-February 2024 revealed 300ml of urine in her bladder, and she was referred to urology. While waiting for an appointment, Evan spent 36 hours unable to urinate and was told by her GP to go to A&E if it got worse.
After feeling dizzy and sick in a supermarket the next day, she went to Medway Hospital in Kent, where a litre of urine was drained from her bladder. She said: "It was so weird. I would sit on the loo and felt no urge whatsoever."
Living with a catheter
After 24 hours, Evan was sent home with a catheter draining her bladder into a bag tied to her leg. She was so mortified that it took five days for her to pluck up the courage to leave the house. "Fortunately I had lots of wide-legged trousers," she said.
Two weeks later, Evan still could not urinate when the catheter was removed and began bloating again. She had a cystoscopy in May 2024, where a tiny camera was inserted into her urethra, and two MRIs in June. In July, urodynamics testing - where her bladder was filled with water to test its function - showed her muscles were unable to release urine. Doctors said she had Fowler's syndrome and would need to be catheterised for life.
Evan struggled with 35 UTIs between February and August 2024 and was hospitalised for sepsis in August, so she was switched to a supra pubic catheter - a tube that comes out of her bladder through her lower abdomen.
Hope for surgery
In December 2025, at UCLH, Evan had a special electronic device implanted at the base of her spine that sends a signal to the bladder muscle to release urine, like a bladder pacemaker, but it did not work for her.
In February 2026, she joined the waiting list for an operation that will make a tube from her appendix to divert her bladder to her belly button, allowing her to connect a tube and open a valve when she needs the toilet. Evan said: "It's really exciting, and scary because it's an eight-hour operation. But the wait is very long and I feel like my life is on hold until then."
She added: "This is mentally debilitating for a woman of my age. People say I do so well with this, but they don't see how much I struggle with it. I wish urinary retention was more widely discussed and known about."
