Paruresis, also known as shy kidney or shy bladder syndrome, is a type of social anxiety disorder in which the sufferer is unable to urinate in the (real or imaginary) presence of others, such as in a public restroom.

It goes beyond simple embarrassment or desire for privacy in that it is much more severe and may cause unnecessary inconvenience, because the inability to urinate, although psychological in origin, is physical in its effect, and not under the control of the sufferer.

The condition does not appear to be generally officially recognised by the UK's NHS or government. However, the condition is catered for in the rules for mandatory urine testing for drugs in UK prisons, and UK incapacity benefit tribunals also recognise it. It has, however, from time to time been the topic of U.S. advice columns such as Ann Landers', to which sufferers have written in and been counseled on their problem.

Severe cases of this disorder can have highly restricting effects on a person's life. Severe sufferers may not be willing to travel far from their home. Others cannot urinate even in their own home if someone else can be heard to be there.

There can be serious difficulties with workplace drug testing where observed urine samples are insisted upon, if the testing regime does not recognise and cater for the condition. In the UK, employees have a general right not to be unfairly dismissed, and so have some defence if this arises, but this is not the case everywhere.

Various strategies to cope with paruresis include:

• avoidance or use of less-busy public restrooms
• using a stall instead of a urinal
• running the tap or flushing to mask the urination sounds

but the above are merely "work-arounds".

Actually treating the condition includes:

• cognitive behavior therapy
• training with biofeedback
• anti-anxiety medications
• using a catheter, although this is alleviating the symptoms rather than effecting a cure.

External links

• International Paruresis Association
• European Paruresis Association
• United Kingdom Paruresis Association