Avoidant Paruresis

[Nappylove]

Hi,

I'm new to the board so go easy on me.

I have a condition called Avoidant paruresis.

I have had this since I was a young kid. For those of you who don't know it, it's when you cannot urinate outside of your own home. I suppose it’s the opposite of incontinence.

I took this off a website and it explains things better than I can:

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Avoidant paruresis (also known as 'bashful bladder' syndrome or psychogenic urinary retention) is a social anxiety disorder that involves the inability to pass urine in the presence of others.

Avoidant paruresis can start at any age and affects mainly boys or men, although girls and women can also suffer from it.

The symptoms are :

# Being afraid or unable to urinate when others are nearby.

# Sufferers worry that someone might knock on the toilet door, or see or hear them urinating, or be waiting patiently outside.

# Feelings of anxiety, anger, and body shyness in provoking situations. These emotions lead to contraction of the internal and external urethral sphincters (circular muscles that voluntarily and involuntarily restrict the flow of urine), both of which must be relaxed for urination.

# Avoidant paruresis usually occurs when using public toilet facilities, including those on trains, buses, boats and planes.

# Producing a specimen for a medical examination can be especially troublesome.

# The condition can also occur at home when there are other people in the house, irrespective of whether or not they are in the bathroom.

# The difficulty disappears if sufferers are certain that no one is around or likely to arrive.

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I have virtually all of the above problems.

As I say I have lived with it since an early age but it can be a hell of a problem when you are dying to use a toilet and you physically can't go.

Anyway to cut a long story short, about a year ago I had hay fever, I suffer every year. I was out working and therefore could not use a toilet. I was dying to go, but, as usual, I couldn’t. I felt as I sneezed I felt a wetness down below and before I knew it, I had wet myself. Luckily, I was close to my car and I had just finished seeing a client (I'm a computer engineer).

I covered my car seat with a carrier bag and drove home to change.

I didn’t think too much about it until it happened again a few days later.

It then got to the stage when I coughed, sneezed ran, I squirted or let go. I had no control over if and when I would let loose.

I saw the doctor and the usual tests were all clear. He then said that as I had paruresis for so many years, I had probably weakened or strained the sphincter. He said I could have some drugs but the side effects were not pleasant and should be avoided, if possible. I did try self cathing, but I ended up with pain when I went and a minor infection, so that route was closed to me. Anyway, it was b****y painful using one!

He said that apart from that, I could try behavioural therapy and I have just started that.

At the moment, I wear disposables. Luckily, I like them because they give me more security when I am out and I don’t have to worry about 'little accidents'

Anyway, that’s my story. Has anyone else heard of this problem and if so, how do you cope?

Sorry it's such a long post!

[Guest]

Curious... can you consciously wet your diaper when you aren't able to use the toilet?

[pctrasher]

Wow, that is the most coincidental thing I've seen in a while. So you had/have shy bladder, then because of it, your sphicter wears out and you become stess incontinent. Another one of those examples where if you go too far in one behavior direction, you're bound to come out the other side. Sounds like it sucks though, hopefully you'll get better...Oh, and as for a temporary fix for shy bladder, drink a few bottles of beer. You get so loose that you'll pee anywhere if you were told you can. I went camping a few nights ago and ended up drinking that night, then when I had to go a friend had to go too and we both went on the hill side standing about ten feet apart. That was insane, and yes, I have moderate shy bladder.

[Nappylove]

Curious... can you consciously wet your diaper when you aren't able to use the toilet?

I managed it once. I was in the country and was able to let go, it took 10 minutes for me to go, though. Unfortunately, it flooded and I had a bit of leakage. I seem to lack control, once I go I can't stop. I suppose that’s what happens when your sphincter or whatever it's called is weak.

I am hoping it will improve with time. Also I hope that using a disposable will help to break down the mind block that I have when going in public, as hopefully, nobody is aware of what I'm doing.

I hope that makes sense, I sometimes feel as if I'm a bit of a freak. I know a lot of people suffer from this, but that doesn’t make me feel any better about it.

[Nappylove]

Wow, that is the most coincidental thing I've seen in a while. So you had/have shy bladder, then because of it, your sphicter wears out and you become stess incontinent. Another one of those examples where if you go too far in one behavior direction, you're bound to come out the other side. Sounds like it sucks though, hopefully you'll get better...Oh, and as for a temporary fix for shy bladder, drink a few bottles of beer. You get so loose that you'll pee anywhere if you were told you can. I went camping a few nights ago and ended up drinking that night, then when I had to go a friend had to go too and we both went on the hill side standing about ten feet apart. That was insane, and yes, I have moderate shy bladder.

The thought of going to the toilet 10 feet in front of anyone else makes me shudder. I would have to be paralytic for that to happen

[nappyloon]

Hi nappylove, thats a new one on me ! it must be like incontinence in reverse until you just "explode" from all that pressure-do you get many Kidney infections due to "reflux" problems?

Glad you feel you can wear "disposables" apparantly without worrying too much about them.

Keep us posted as to how you get on.

Good luck.

[Nappylove]

Hi nappylove, thats a new one on me ! it must be like incontinence in reverse until you just "explode" from all that pressure-do you get many Kidney infections due to "reflux" problems?

Glad you feel you can wear "disposables" apparantly without worrying too much about them.

Keep us posted as to how you get on.

Good luck.

That is what my doctor is worried about. Kidney infections are no fun. Also the chances of chronic prostatitis are high. I've been lucky so far, only a few minor problems in that department, but as I get older, the chances are that I am going to have more serious issues.

I don't worry about wearing a nappy because it gives me a small amount of relief from worrying about a public 'incident' lets face it no one notices that you are wearing one, well no one has mentioned it anyway. Perhaps people in the UK are too polite

My wife knows about the problem and is very supportive. If she wasn’t happy about my wearing a disposable, then I would probably be more upset. Mind you she works in a nursery and changes nappies for a living!

[Frink]

I don't think I qualify as a member of the "o shit medical condition" club, but I find that I can't go in a stall unless there's a separator between me and the other urinals. It just weirds me out, I guess. :?

[beallucanb]

Frink, I was sorta like that when I was aroud your age, but the need to go eventully won out, but I still can't do a No.2 is there is someone around, I only go in my own bathroom.

[Dill_Pickle]

Hi,

I'm new to the board so go easy on me.

<long story about shy bladder clipped>

Anyway, that’s my story. Has anyone else heard of this problem and if so, how do you cope?

Sorry it's such a long post!

Hmm, I'd call that either stress or overflow incontinence...your body letting you know you are holding too damn much....and yes, your kidneys need to have less pressure on them...hopefully you didn't hurt yourself with the impulse of pressure when you sneezed...I remember a guy from high school with the paruresis problem. You might want to think about general relaxation/stress relief; mindfulness/shambala can be done in parallel.

so I'll give you my method of making relatively cheap disposable diapers not leak...buy (in the US) a Tena/Serentiy ladie's pee pad, ultimate absorbency, and stick it in the front of your diaper....don't bother with slitting the backing or anything....

Now, what should we do to be hard on you (grin)? We'll give you the DailyDiapers "twelve-step" (?) (un)training plan.... don't take it too seriously....

1) admit you have a problem in your head

2) admit the problem is ALL in your head...but if you don't solve it, the physical end is dangerous to your health....shrinks don't care if you wear diapers, they care how much the wearing interferes with the rest of your life, so:

3) Relax....wear diapers constantly (many of us here actually like to do this)

4) Realize that if you don't tell others, they won't know even if your diapers crinkle a bit...

5) Pee in your diaper, whenever you need to go, and only in your diaper. This will loosen your ability to hold your pee a bit...

6) Step 5 won't come immediately, keep practicing....

7) If you practice repeatedly, your diapers won't leak....

8) Wear dark blue or black pants, they conceal leaks anyway...

9) Drink plenty of fluids, about two quarts per day for no exercise, enough to make you pee right after exercise if you are doing any exercise. Don't drink soda, drink beer or water...

10) Do this in parallel with whatever your professionals have been telling you to do

11) Do a "Dog walk"...fill up on water, go for a walk, pee a bit every fifty yards or so...

12) Stop this process only when you can pee in the stalls at a crowded airport bathroom, or, failing that, you shock someone by peeing freely right in front of them. A third possibility would be to pee with your boss at the next urinal.

[pctrasher]

Now, what should we do to be hard on you (grin)? We'll give you the DailyDiapers "twelve-step" (?) (un)training plan.... don't take it too seriously....

1) admit you have a problem in your head

2) admit the problem is ALL in your head...but if you don't solve it, the physical end is dangerous to your health....shrinks don't care if you wear diapers, they care how much the wearing interferes with the rest of your life, so:

3) Relax....wear diapers constantly (many of us here actually like to do this)

4) Realize that if you don't tell others, they won't know even if your diapers crinkle a bit...

5) Pee in your diaper, whenever you need to go, and only in your diaper. This will loosen your ability to hold your pee a bit...

6) Step 5 won't come immediately, keep practicing....

7) If you practice repeatedly, your diapers won't leak....

8) Wear dark blue or black pants, they conceal leaks anyway...

9) Drink plenty of fluids, about two quarts per day for no exercise, enough to make you pee right after exercise if you are doing any exercise. Don't drink soda, drink beer or water...

10) Do this in parallel with whatever your professionals have been telling you to do

11) Do a "Dog walk"...fill up on water, go for a walk, pee a bit every fifty yards or so...

12) Stop this process only when you can pee in the stalls at a crowded airport bathroom, or, failing that, you shock someone by peeing freely right in front of them. A third possibility would be to pee with your boss at the next urinal.

That's one heck of a twelve step Dill, I'd say just copy that and pm it to DD and see if they will put it up as a sticky at the top of the general discussion thread to prevent ppl from asking how they can become incon...which I do have to admit hasn't happenend in a while.

[nurse_lover]

I unfortunately have severe avoidant paruresis. It is especially bad in public restrooms, so much so I can not go in them at all. This makes road travel difficult, though I have learned to look for smaller "mom and pop" type gas stations, which usually have a private bathroom. This is also useful for diaper changes on the road, but thats a bit off topic here. I am not sure how much has been considered on the psychological aspects of paruresis, but I can actually remeber where mine started, which was in fifth grade. I was always modest, but with puberty hitting classmates, there was a lot of pressure to measure penis size for bragging rights, and I did not want to participate. On several occasions, classmates tried to look when I was peeing to see how "developed" I was. I must emphasize that there was never any touching involved. I also got bullied a lot, and the bathrooms never had teacher supervision, so it was a prime spot to be bullied. Over time, I started not being able to go around other people, at times having my kidneys in searing pain, but still not being able to urinate. To this day, that holds true, though working in a small office makes it easier to know that none of my co-workers are in the bathroom when I go in. Even the medicines my psychiatrist prescribed for social anxiety and depression do not help with this issue. Is it really possible that this could cause long term damage to my urinary tract? Sometimes, after I finally manage to go, I get a small dribble into my underpants afterwards, and worse off are the times when I have pains in my kidneys lasting well after I urinate.

Changed "psins" to "pains"

[Nappylove]

Hi nurse_lover

I can relate to the things that happened to you. With me, I can trace it back to when I was about 7 in infants school.

My problem was that in my school, you only went to the toilet at break times. The toilets were at the end of the playground and to cut a long story short, I was too late, I wet in my pants, worse as I also had a loose bowel movement as well and everyone saw me. I could have died with embarrassment.

This happened twice and I remember now the shame I felt about this and it's stayed with me until now.

People who do not have this condition cannot understand how you can be bursting to go and yet can't go in public situations.

With me it's so bad that even at home, if my wife or anyone else is near the toilet, I can't go.

Since wearing nappies, it's helped because it gives me a feeling of security, I know I dribble a bit due to my weakened muscle and sometimes it gushes when my sphincter won't let me hold it anymore, but at least now I can go without anyone noticing.

I still hold it in when in public and I'm hoping that therapy, exercises and assurance of nappies will help me through.

It's good that my wife is understanding, without her it would be much harder.

[nurse_lover]

Thats a lot worse than mine. I live with my parents, and am able to use the bathroom, even if they can hear me. Dating has been difficult though. Last girl I dated had the bathroom right next to the bedroom. I was not able to go at all when she was in the bedroom, and my saving grace was that she would have to go walk her dog outside from time to time. One night was particularly rough, as we slept late. I had to go so bad that I ended up leaking out a little, fortunately not enough to soak through my sweatpants. She ended up breaking up with me that weekend, and I still am not sure if this had anything to do with it.

[Dill_Pickle]

That's one heck of a twelve step Dill, I'd say just copy that and pm it to DD and see if they will put it up as a sticky at the top of the general discussion thread to prevent ppl from asking how they can become incon...which I do have to admit hasn't happenend in a while.

PCtrasher:

I think we could add it to the "Purpose of incontinence forum" thread....what I would say here is that for some, hypercontinence is a problem...just that on average, loss of control is not a good thing...I'm OK with making my list a permanent fixture of the DailyDiapers site.

Good luck for all those with shy bladders...let us know how you succeeded in overcoming them. Remember, diapers are a potential tool for this situation. I wonder if CISC (Clean intermittent self-catheterization) is also a solution?

Dill Pickle