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Andrew, following on from Joe's sad message & my comment, do you have any knowledge on what else physiologically causes an inability to pee, as opposed to an emotional block?. If I tried harder to confront this problem, is there something realistic that can be said in an embarrassing situation. If I was keeping someone waiting behind me for example could I say I have kidney stones perhaps to explain. I think this might help me. The truth might be better, but I can't see that happening. A small white lie may just help me to relax enough. More to the point something to say to relieve the tension, which I accept would probably only exist in my head, may just help enough for me to stop the avoidance bit of avoidance paruresis.
Re other physiological reasons for not being able to pee: that's out of my sphere of competence :-( However here goes.
Depending on your age there is the prostate, which gradually chokes off the flow in older men; hence the apple corer op (ouch).
Then there is a condition where the exit from the bladder into the urethra is narrowed: a very simple op corrects that.
A urologist could probably provide several more causes.
I am a great believer in the power of having a script in your head for the question that will almost never be asked. Having the script there does, as you suggest, calm you. The trick is to be economical with the truth. You definitely do NOT have to either explain or justify; instead:
"Hurry up mate"
"sorry, it takes as long as it takes" or "I'd love to but me prostate's on a go slow" or "me bloody waterworks are playing up again" or "sometimes I just can't seem to get started".
One guy posted that in frustration he said the last one above aloud to no-one in particular and another guy piped up: "tell me about it, I call it stage fright". It made him laugh, which resulted in his peeing.
As Andrew said, it is the question that will almost never be asked. It is a worry for us AP's that this quiestion will be posed as it would concern a fairly high level of embarassment - it certainly would in my case that's for sure. However, the easiest response, and natural one for that matter, would be to turn to the bloke and say 'what it's gotta do with you'. Mind you, we AP's are not of that nature, are we?!! It is the thought of being embarassed about something which we are embarressed to do!