Paruresis (paruresis, shy bladder)

Paruresis.

Often in an unusual environment, especially in the presence of strangers, some people experience problems in coping with natural needs – urination in such a situation becomes impossible even with a strong desire. It is this condition that in modern urology, neurology and psychiatry is called paruresis or shy bladder syndrome. This condition is not a disease in the full sense of the word; the name pathological condition is more suitable to it, because in a calm home environment, problems with emptying the bladder usually do not arise.

Causes of shy bladder syndrome

Patients, the majority of whom are men of a fairly young and active age, note that SSMP first appeared in them in adolescence, when any careless remark or comment is not always adequately perceived. So it turns out that for one stupid word or stupid joke, a person with increased nervous sensitivity pays with suffering throughout his life. A person cannot study, work, visit or travel normally – he constantly remembers that going to the toilet can end in complete disaster, and in the worst case scenario, medical assistance may be required.

Foreign researchers believe that a certain role in the development of paruresis belongs to certain medications that change the ratio of mediators in the cells of the nervous system, which can provoke the development of foci of stagnant excitation and disruption of the transmission of nerve impulses through neurons. Such drugs provoke spasm of the urinary tract sphincters, as a result of which the muscles cannot completely relax.
Also, shy bladder syndrome can occur in patients who suffer from certain diseases of the nervous system associated with impaired impulse transmission (multiple sclerosis). A certain role is assigned to infectious agents – fungi of the genus Candida, which are usually safe for most men, in combination with an unfavorable psycho-emotional background provoke the development of the initial phenomena of paruresis.

The causes of shy bladder syndrome have been actively studied recently precisely because up to 90% of adults experience manifestations of this condition at least once in their lives, and 10% of adult men suffer constantly when faced with a similar disease.

Who is at risk from paruresis

This disease is most susceptible to men of young active and working age, who in childhood and adolescence had certain problems with adaptation in a team, psychological difficulties when communicating with peers or people of the opposite sex. Recently, the frequency of paruresis is significantly higher; in people with activities associated with stress, the frequency of paruresis reaches 12%.

Manifestations of shy bladder syndrome

Most patients note that in the initial stages of the disease, problems arise when it is necessary to use public toilets or relieve natural needs on the street in the presence of strangers. Then it becomes impossible to empty the bladder in a public toilet, even alone, and in advanced stages of the pathological process, patients can hardly urinate even in the toilet of their own home – some patients need complete solitude, silence and a closed space.
The first descriptions of SSMP are given in the scientific works of the great Russian physiologist V. Bekhterev, but a close study of this problem began only after the appearance at the end of the last century of the works of the American doctor Stephen Soifer, who organized the International Association of Persons Suffering from Paruresis (IPA).

Treatment of paruresis

Currently, treatment for shy bladder syndrome mainly consists of psychological correction of emerging problems and training of the muscles that are responsible for urination. Attempts to use tranquilizers and sedatives to treat SSMP have not been successful – the problem is that the drugs need to be taken for a long time, and these medications can be addictive and dependent.

The main place in the treatment of paruresis today is given to training – patients are taught to feel their body and control the process of emptying the bladder. In this case, it is recommended to evaluate the bladder filling scale on a 10-point scale: in this case, an empty bladder corresponds to 1-2 points, a partially filled bladder corresponds to 3-5 points, a sufficiently filled bladder corresponds to 6-8 points, and a full bladder corresponds to over 8 points.

In this case, patients are advised to go to the toilet with a sufficiently full bladder, since when it is overfilled and overstretched, the chance of urinating normally is significantly reduced, and in some cases, medical assistance may be required – bladder catheterization.

Prevention of unpleasant situations
In some situations (during long flights or transfers, celebrations), the doctor may recommend special medications to patients with paruresis that slow down urination. But these funds can only be used according to strict indications and under the supervision of a qualified physician. Also, to limit urine formation in “difficult” situations, it is recommended to limit the amount of fluid you drink, drink coffee and large amounts of tea, and eat dill, parsley, lingonberries, watermelon and melon.

Instead of an afterword.

The problem of paruresis is a pathology on the verge of psychology, urology, psychiatry and neurology. Patients with paruresis often lose hope of getting rid of the symptoms of the disease, traveling from specialist to specialist. The problem is that this pathology, unfortunately, is not included in the training program of a medical specialist in any specialty, and even very prominent doctors have often never heard of this problem. We professionally deal with this category of patients, we will be happy to help you too!