For General Practitioners

How can GPs help their patients

For most people who experience paruresis, the recommended first medical visit should be to their GP to rule out any possible physical reasons for the urinary difficulty.
This article in the "What Your Patient is Thinking" series appeared in the BMJ in October 2021.

GPs and other health professionals can find more information in our leaflet about how to deal with paruresis when they first encounter it

These two articles from the Royal Australian College of GPs report on the latest thinking on paruresis and parcopresis, and outline ways in which GPs can help sufferers.

Paruresis and the Disability Discrimination Act

An extract from the Income Data Services Handbook of Disability Discrimination illustrating its relevance to paruresis

Nursing Times Article

An article from The Nursing Times where Andrew Smith, chair of UK Paruresis Trust, explains what paruresis is and how people are affected by it

Intermittent self-catheterisation for managing urinary problems 

A significant minority of cases of paruresis are severe i.e. they cannot pee away from home, and they experience retention even there. Their day-to-day life is very stressful, so much so that it interferes with effective therapy. Such cases find either temporary or permanent relief from symptoms by learning clean intermittent self-catheterisation. Just knowing that the catheter is in one’s pocket as a fool-proof last resort, can in some cases eliminate enough of the anxiety to allow the individual to do without it. The catheters are disposable, single-use, sterile, and self-lubricated. In our experience infections in men are rare; however infections among women are more common for physical hygiene reasons.

It should be recognised that urinary retention by such individuals is absolute: the effect of the autonomous nervous system being to relax the detrusor and close the internal sphincter, hence however full the bladder, the sphincter will stay closed.

The following article by continence nurses makes the case for personal control of self-catheterisation in order to enable a normal daily life. As such it can enable an individual to undertake a therapeutic process of Cognitive Behaviour Therapy; also to undertake air travel since without a catheter, the individual would be in retention until arrival at a safe destination such as a hotel.  

The Urology Care Foundation (“powered” by trusted experts of the American Urological Association) goes as far as to suggest that individuals be taught self-catheterisation on the grounds that it “leads to relief right away and better quality of life. The low risk for healthy people in using catheters far outweighs the harm of ongoing disruption of one`s life by shy bladder.”
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Last review date: January 2023.
Next review date: January 2026.

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