Posted by Andrew on 8/6/2011, 9:05 am, in reply to "Re: Shy Bladder and Treatment"

Hi Sam There is no direct link that I am aware of. CUR is a physical condition, whereas paruresis is a psychological condition. Because an individual can become self-conscious and anxious because of delays in being able to urinate, the physical condition could in some cases be the pre-cursor to paruresis. The other way, severe paruresis, whereby the individual is repeatedly prevented from voiding by "unsafe" circumstances, could possibly lead to physical symptoms similar to those of CUR. I say "could" because the individual is usually prevented on only an ad-hoc basis, and not continually. CUR seems to be due to physical obstruction: I'm sure you have googled the term and read this. Others have told me about being diagnosed with a constriction where the urethra leaves the bladder: a minor op to make a small incision, so widening the exit, seemed to work. But there are other causes of obstruction, so you would be well advised to get a referral to a urologist to get a physical check up. The symptoms you describe are worth examining. Small bladder size: this is not a two way symptom. i.e. having a small bladder does not mean you get CUR; it just means you need to pee more often. The other symptoms: these can be due to physical obstruction. In men it is usually later in life due to an enlarged prostate, but there are other causes as well that can apply at any age. The one caveat is that it has been shown that tension and anxiety when peeing can result in a long hesitancy period, a weak flow, and inadequate emptying. That thes symptoms have improved as your CBT has progressed is interesting in this regard, suggesting that the psychological aspect is present. As for getting up in the night, are you drinking near bedtime: are you drinking a diuretic? Try avoiding a drink say less than two hours before bedtime. But the bottom line has to be, get checked out by a urologist; we always advise that, just to be on the safe side. Who knows? There could be both physical and psychological causes at work here. best wishes Andrew

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