Paruresis is a phobia of urinating in public or in the presence of someone else. It is not caused by a physical blockage that prevents urination, but it is the psychological fear of urinating without sufficient privacy that interferes with the process.
This disorder can affect an individual’s quality of life substantially, to the point that people who suffer begin altering their behavior to avoid the need to urinate in public situations. They may not attend public events or may monitor their fluid intake to lessen the need to urinate in uncomfortable situations.
People of any age can be affected by paruresis and it occurs as a result of psychological reasons. There is nothing physically wrong with the urinary tract and everything functions normally under normal conditions in privacy.
Often it is possible to identify a certain trigger point or situation which led to the fear of urinating in the presence of other people, although this is not always the case. Children may be subjected to teasing or harassment in public toilets, leading to symptoms of paruresis.
Difficulty in passing urine in public bathrooms is the main symptom related to paruresis, although there are other symptoms that may stem from this.
In particular, anxiety about using the bathroom in public can be problematic for some and may induce heart palpitations, sweating, dizziness and shaking. Additionally, it may cause people to alter their behavior by restricting fluid intake and avoid public events, which inhibits their quality of life and can pose possible health risks due to dehydration.
Diagnosis & Treatment
It is important to establish that the functionality of the urinary tract is normal and the problem is purely psychological before diagnosis with paruresis. If the individual can urinate normally in the privacy of their home but have difficulty in public, this is a good indication.
Psychotherapy can help patients to learn how to solve their problems through counseling and learning relaxation techniques. Graduated exposure therapy, which involves attempting to urinate in increasingly more difficult places, can help people to gain confidence and overcome paruresis.