Ask a doctor on the topic of Urology

Is it possible to be a shy introvert at home as well?

August 23, 2013 | 25,00 EUR | answered by Dr. med. Olaf Stephan

I suffer from a shy bladder and cannot urinate in public restrooms. I have heard that this problem can also occur at home and when alone. I asked my urologist about it, and he told me that it can happen. Now I am very afraid that I will wake up in the morning with a full bladder and not be able to urinate. I even experience pressure in my lower abdomen in the evenings due to this fear. Medically, everything is fine with my bladder and I have never had any issues with urinating before.

Now, my questions are:
1. Is it really possible that the fear of not being able to urinate in the morning can actually cause it to happen?
2. If so, what can be done in this specific case to be able to urinate again?

Dr. med. Olaf Stephan

Dear inquirer,

With the problem you described, you are not alone, an estimated 5.7 million German citizens have a panic fear of public toilets. The exaggerated form of this phobia is called Paruresis, also known as "shy bladder", it is a psychological disorder with sometimes quite high levels of suffering. In the majority of cases, Paruresis occurs when using public toilets, the problem arising when using your own (domestic) toilet would be extremely rare, but is conceivable in individual cases, as your treating urologist rightly pointed out. However, from your description, it can also be seen that you have not had any difficulties so far in your home environment, and therefore it seems very unlikely that you should have problems urinating at home in the future. If this unlikely event should occur, you still have the option to see a doctor or an emergency department, where the bladder can be easily emptied using a catheter. There is currently no medication treatment available. However, it is possible to treat the phobia (fear) using psychological behavioral therapies, and learning deep relaxation exercises such as autogenic training or specific breathing techniques is also recommended.

Best regards,
O. Stephan