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Urination Anxiety/Phobia


FredHes
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I've had paruresis (shy bladdder) as far back as I can remember, but it never had a great impact on my life. I could usually always go to a stall and pee. I could go to movies, concerts, restaurants, etc....no problem as long as I could go to a stall. In spring of 2006 I developed Peyronie's and from the first day I felt the symptoms (a kind of "irritation" in the penis), I locked up and had a very hard time going even at work. I worked with a therapist that summer and finally through graduated exposure was able to go at work, but usually to only one restroom where I had become comfortable. I retired in 2008 due to this problem and some other health issues and since then things have spun out of control. I can't pee at restaurants, movies, concerts, etc. so now I've become a virtual recluse. I feel very badly for my wife as we used to do all kinds of things together, now I'm not able to take her anywhere. I'm a retired music teacher and have a few privates students at home. I can't pee if there is a student or parent in the house. In the last 4 or 5 months another very perplexing problem has come up. At random times when I go to pee I'll suddenly start to shake (fight or flight response) and the stream will either get very weak or stop which causes pain, I suppose due to the Peyronie's and the urethral sphincter suddenly clamping shut. Now I have problems with these lockups when trying to empty my bladder 30 minutes before a student arrives.

Paruresis is described as the fear of not peeing..now I have that and also the fear "of peeing"...a double whammy. I've come up with all kinds of OCD type rituals to make myself go (distractions I suppose). At first I'd let the urge build up very high, stand in the bathtub and pour warm water on my penis. This worked for a while, but sometimes fails. Now I sometimes go ooutside, pour cold water on myself followed by warm water on penis, sometimes pee sitting down, etc. Sometimes these things work...sometimes not. Funny thing I can get up during the night, stand in the tub using the warm water and go with no problem. Once my wife gets up before me I'm not able to go.

I have a very old friend who's a therapist and he has recommended a therapist who is a leading expert in these type of conditioning syndromes. He works with the police dept., with undercover cops and swat team guys. I feel he could help me but my problem is the paruresis. The very thing for which I need treatment is preventing me from going. I know I'll be sitting in his office with a full bladder and no place to pee. The strange thing is I know this is a conditioned response. It's something I'm causing to happen because I can feel when it's going to happen. My subconscious is turning on me. I'm looking for suggestions as to how to approach getting into therapy. I could drink less water and pee just before going but more than likely I'd lockup from the pressure. It seems like a no win situation to me and I'm at my rope's end. My Dr. has raised my Valiium to 30 mg per day as needed and this seems to help some but still hasn't solved the problem. I feel sure that CBT will help, but....how do I go see the doc?

Fred

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Hi Fred, welcome to the forum.

You situation sounds very challenging and not easy to live with. I'm not a professional so unable to offer any advice, but we do have some professionals in the forum and I'm sure they will chime in eventually.

I hope you find a solution so that you can resume your regular life again....

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Hello, Fred, and welcome back.

This must be so painful and frustrating for you. I'm sorry you've been going through this. I'm no professional either, but this does sound anxiety-related. Therapy could definitely be helpful. I would suggest being very honest with the therapist and telling him what you've been experiencing. I know from my own anxiety that it can feed on itself and this can make things worse. Are you concerned about having physical discomfort with this during a session?

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Guest ASchwartz

Hi Fred,

If you do a search on our web site you will find several articles on paruresis. It is more common than you may think and afflicts both men and women. Just for the sake of accuracy, Paruresis is the fear of urinating in public places.

There are many types of conditioning techniques to reduce the symptoms of paruresis and you should see a psychologist who uses cognitive behavioral methods. You also need to learn and use anxiety reducing methods on your own.

Peyronies is "bent penis" and is a separate problem. It too is common. I recommend that you see a urologist as soon as possible so that you can get help on how to deal with it including eliminating pain on ejaculation and urination.

There are many books on each of the two conditions.

Hope this helps.

Allan

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Hi Fred,

If you do a search on our web site you will find several articles on paruresis. It is more common than you may think and afflicts both men and women. Just for the sake of accuracy, Paruresis is the fear of urinating in public places.

There are many types of conditioning techniques to reduce the symptoms of paruresis and you should see a psychologist who uses cognitive behavioral methods. You also need to learn and use anxiety reducing methods on your own.

Peyronies is "bent penis" and is a separate problem. It too is common. I recommend that you see a urologist as soon as possible so that you can get help on how to deal with it including eliminating pain on ejaculation and urination.

There are many books on each of the two conditions.

Hope this helps.

Allan

I've seeen 2 urologists already. One completely missed the Peyronie's, the other (chairman of the urology dept. of a well known university) told me to take 200 mg vitamin E per day and come back in 6 months. Peyronie's is an incurable condition. There are several oral treatments which have helped some people with their symptoms (pentoxifylline, ALC, and some others), but none is a cure. I was on pentox for about a week and had to get off because it increased my anxiety (a side effect). There are also surgical procedures but the condition has to be stable before a surgeon will perform any of the procedures. I've been in touch with one of the leading experts on Peyronie's (at Vanderbilt) and his response was "we don't treat primary pain syndromes" (I've had pain for over 4 years...typically the pain goes away in 6 to 18 months), so mine is not a typical case. Believe me, I've done much research on this dread condition and to simply call it "bent penis" is a gross oversimplification. It has made my life a living hell for over four years and also caused my paruresis to spin out of control. It also makes it very difficult to do the graduated exposure work necessary to deal with paruresis as this typically involves going to different restrooms, peeing for about 3 seconds and stopping to save your urine for the next stop. Also this new thing I've developed (the "fight or flight" rsponse to peeing) is something I've never heard of anyone else having (although I'm sure some do). As I mentioned I've been referred to a very good therapist who's had a lot of success treating paruresis, but I'm avoiding going for the very thing I need to be treated for...paruresis. I know I won't be able to pee at his office or probably not even before I leave home. Last week I had an appointment with my psych dr. and had a lockup trying to pee just before leaving for the appointment. I feel as if I'm at a dead end.

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Is there any way you might express your concerns to the therapist before attending your first session? Could you call him or write an email? Maybe he might have some suggestions for you? You mentioned having no difficulty urinating during the night. Could you make an early AM appointment? I can see how one condition could adversely affect the other. I'm sorry this has been causing you so much pain and distress. I hope the therapist is able to help you, Fred.

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Is there any way you might express your concerns to the therapist before attending your first session? Could you call him or write an email? Maybe he might have some suggestions for you? You mentioned having no difficulty urinating during the night. Could you make an early AM appointment? I can see how one condition could adversely affect the other. I'm sorry this has been causing you so much pain and distress. I hope the therapist is able to help you, Fred.

IrmaJean,

Thanks for your support. I was thinking of giving the therapist a call to discuss the problem as you suggested. Sounds like a good idea.

Fred

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