Urinary retention: identify your problem based on your symptoms

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Urinary retention is often embarrassing because, of course, it causes problems in the toilet, but also because people do not dare to talk about it or consult a specialist.

In some cases, such as shy bladder, one can be affected for decades without knowing that it has a name.

My goal is to list 3 common urinary disorders with their symptoms so that you can put a name to what is affecting you. Because being able to put a name on our problem is an important step to be able to act on it.

Here are the 3 urinary retention troubles I've picked:

Paruresis (Shy Bladder Syndrome)

Symptoms:

Paruresis or "shy bladder" syndrome, is the inability or great difficulty to urinate when you can be seen or heard by others, or when you think you can, or when you are in a hurry.

Causes:

Paruresis is a social phobia.

As is often the case with phobias, traumas from the past are linked to it, such as things experienced at school (teasing, bullying, being caught in the toilet...) or in the family (remarks by an elder, remarks by parents…). These events may or may not be conscious.

Solutions:

Behavioral and cognitive therapies (CBT), EFT, EMDR, NLP, hypnosis, gradual exposure therapy...

Dysuria

Symptoms :

Dysuria is an urination disorder where the person has a weak stream of urine or has to "push" to force the release. The bladder contraction is not sufficient to produce a sufficient urine flow. Pain and discomfort sometimes accompanies dysuria. 

Causes :

For women: usually due to an infection such as cystitis or others, most often caused by sexual intercourse. Another cause is a descent of organs (uterine prolapse) that interferes with the normal functioning of the bladder.

For men:
usually an increase in the volume of the prostate that compresses the bladder or the urethra.

Solutions:

Medication for bacterial infections. Surgery for urinary or genital tract obstructions.

In all cases, consult your urologist.

Acute Urinary Retention:

The capacity of the bladder varies from person to person, but in general, the urge to urinate is triggered at about 10 fl. oz (300 ml) of filling for an adult male. If the evacuation of urine is impossible, the bladder continues its permanent filling (2 fl. oz/h or 60 ml/h) without emptying. It is the sudden tension of the bladder muscle (detrusor) that causes the pain.

It is a common situation in men, and the frequency increases with age.

Causes:

For women: the main causes of acute urinary retention are an abnormal descent of the bladder into the pelvic cavity (prolapse), the immediate aftermath of childbirth due to stretching of the bladder nerves or uterine surgery.

For men: 
In 50 to 70% of cases, acute urinary retention is the natural evolution of a benign hypertrophy of the prostate that has been ignored for too long.

Solutions:

It is a medical emergency, and therefore it is necessary to call the emergency  to proceed with the emptying of the bladder by placing a urinary catheter.

Video Transcript

"Hi, in this video I'm going to talk about urinary retention and the point of this video is to for you to define in which category you fall into because there are several kinds which are totally different and once you know which category you fall into then you can take the necessary action to help you overcome this problem.

So in this video I will describe the three main kind of urinary retention starting with the symptoms, their causes and then the possible solutions although it's not the most important in for this video. Let's start with the first one which is paruresis also known as shy bladder and it's defined by the impossibility or huge difficulties to urinate while we can be seen or heard by others or when we think we can be or also when we are in a rush.

I know it very well because I lived with it for 17 years and you know you are affected by this one when you can actually manage to pee generally in your home when you are alone when you for you you feel the environment is safe enough for you to pee and when you do so you have no pain whatsoever and you have no problem really you don't feel any problem physical problem. The same with paruresis it's like you can really feel the block when you are surrounded by other people or you know you are fearing to be heard or seen and you can feel you have a muscle block really that that comes like a signal from your brain somehow and then it blocks your bladder and then you you cannot do anything but when the conditions are safe, safe meaning it depends for every person is different on what safe is when you are in a safe environment then you have absolutely no problem peeing.

The causes since it's not something physical it's it's something in the in our mind basically it's a social phobia basically that's what it's a social phobia and the trauma generally comes from our past can be you know school events or family you know someone said some something bad to us and also generally it comes with a lot of self-perception, in general people with shy bladder tends to be shy they lack confidence in themselves we compare ourselves a lot with to others you know we have a feeling of inferiority somehow. When it comes to the trauma from the past those can be conscious so we know where it comes from but in most of the case it's unconscious like we don't remember exactly where it comes from but somehow the mind has made a construction and to create this phobia that's why the it can appear several years after the actual event in general it occurs in high school.

So in terms of solutions cognitive behavioral therapy (CBT) emotional freedom technique (EFT), EMDR, NPL, hypnosis or gradual exposure are techniques that are well known today to be effective to treat this kind of condition which is a phobia.

So the second type of urinary retention is called dysuria. Dysuria the symptoms are it's like a disorder of micturition which is a complicated word to say urination basically and so it's a disorder of urination where the person has a weak stream of urine and or the person has to push to force evacuation so basically what it means is like the bladder contraction is too weak to produce a sufficient urine flow and in some case pain is felt. So in terms of causes, for women cysticis or other infections mostly caused by sexual intercourse or organ descent also known as prolapse and for men the causes will be like an enlargement of the prostate compressing the bladder or urethra.

So in terms of solutions medication can be used for everything related to bacterial infection and for the other case surgery might be necessary for urinary or genital tract obstruction but in any case ask and see your urologist to know the course of action you should take.

The third case of urinary retention is acute urinary retention. This is the most severe case and it involves acute pain due to the inability to urinate and empty the bladder which continues to fill up. So normally when the bladder reaches a certain level we get the will to to urinate simply put it but for the people which fall into this case they cannot do it and obviously the bladder continues to fill up and it triggers obviously tremendous pain. So for the causes for this urinary retention for women it could be an abnormal descent of the bladder into the pelvic cavity generally following a childbirth or uterine surgery and for men it could be a benign prostatic enlargement too long ignored. For men this is like between 50 and 70 percent of the case.

Here in terms of solution there is not a thousand of them it's a medical emergency and you need to go to the ER to empty the bladder with a urinary catheter.

So this is the most extreme case of urinary retention. All right so I hope this video has helped you to identify in which in which case you fall because I know for me it wasn't the case when I had a shy bladder syndrome. I didn't even know it existed. So that's why I decided to do this video and so I hope you know you can define in which case you fall. If you have found out that you have a shy bladder also known as paruresis then you will you can check the link below this video to get some help to get some resources to help you do your first step towards the recovery and eventually overcome the shy bladder syndrome. I'll see you in another video and thank you for watching bye."

About the Author : Guillaume

I'm a man who lived 17 years with a shy bladder.

Today, it's part of my past, but I've decided to help others free themselves from this nightmare that greatly affects the quality of life.

I've lived abroad many years and consider myself a citizen of the world, but I can't do anything for being born in France, so forgive my accent in the videos 😀

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