Fear of urination (paruresis)

For most people it is self-evident that if you feel the urge to urinate, you can go to the toilet without any problems. The moment you start worrying about going to the toilet in advance and are especially afraid of public toilets, a social phobia can arise: you have a fear of urinating and can no longer urinate. This involuntary holding of urine is also called urinary anxiety or paruresis. What does this mean and how can you treat it?

What is urinary anxiety?

Urinary anxiety, also called paruresis, is a fear of urinating. This especially occurs when someone has to visit a public toilet. For most people this is not a problem, but there are also people who have a phobia and are unable to empty their bladder due to fear of urination. These people try to avoid public toilets as much as possible and plan their toilet visits in advance. The thought that one cannot urinate in complete privacy creates a blockage that makes urination impossible. There is no physically identifiable cause for this form of involuntary retention of urine. Being mentally busy hinders physical functioning. This condition is also sometimes called shy bladder.


Both psychological and physical causes can underlie this. It has not yet been proven that heredity plays a role, but it is suspected that it does. Often it is not possible to clearly indicate what the cause is. Usually something has happened that has given you a phobia about urinating in public. This could be, for example, because you wanted to pee in a public toilet, knowing that there were people waiting for you. The time pressure makes you nervous and you try with all your might to urinate. This causes so much stress that the bladder no longer seems to function. This condition is slightly more common in women than in men.


People with paruresis are already busy thinking about their toilet visits if they have to leave the house all day. They try to avoid going to the toilet and this can lead to a phobia. Stress can cause all kinds of complaints such as palpitations, sweating, dizziness, nervousness, pain in the bladder and trembling. There are also people who do not experience this, but are simply unable to urinate and still have a full bladder after visiting the toilet. Because of shame, some people find it very difficult to talk about this problem. Yet it can have a major impact on your life. For example, if you no longer dare to drink outside the home and if you would rather not go out at all. Urinating at home in peace usually does not cause any problems.


Creating a background noise, for example by letting the tap run or flushing the toilet before urinating, can temporarily solve the problem. It can also cause the phobia to eventually get worse. If this condition poses such a problem that it hinders your daily functioning, some people end up seeing a urologist. If no physical problem is identified, the diagnosis of urinary anxiety is quickly made. Behavioral therapy seems to be the most suitable treatment for this. With this treatment you gradually learn to urinate near other people. Eventually you will be able to urinate in a public space again. The fear can sometimes come back, but you can usually deal with it well.


Once a phobia has developed, it usually cannot be resolved on your own. But sometimes you can do something about it yourself. This way you can avoid busy and public toilets. If you have to go to the toilet outside, look for a restaurant nearby because the toilets there are usually quieter and more closed off. As a man you can visit a toilet cubicle instead of a urinal. It can also work well if you honestly admit this problem to your partner, friends or family so that they can understand it. This can make a day out a lot more fun.

read more

  • The importance of a clean bladder
  • Causes of urine loss and what can you do about it?
  • Self-care for bladder infections
  • Bladder disease: benign and malignant growths
  • Pelvic inflammatory disease: PID (pelvic inflammatory disease)
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