Q:  Is my diet a factor in paruresis?  Can I help my recovery by changing it?

A: Drinking more fluids helps to improve the health of the urinary system, so that can be helpful for recovery. People dealing with urinary tract infections find that cranberry juice is effective in reducing or eliminating infection. Substances that increase anxiety, especially caffeine, should be avoided or used with care. Caffeine does stimulate urine production and some people have noticed that drinking tea, which contains low to moderate amounts of caffeine, can be helpful in graduated exposure practice. Caffeine does have the useful characteristic that dosage is relatively easy to control by drinking a certain amount of coffee or tea. Alcohol has effects that are more difficult to predict. Because alcohol can relax muscles in the body, it may improve the ability to relax the urinary sphincter. However, in many people it relaxes the bladder muscle as well, which reduces the urge and ability to urinate. People tend to control their alcohol intake less reliably, especially if they drink more heavily.  For this reason IPA does not recommend use of alcohol during graduated exposure therapy, or as a method of making the work easier. See the more detailed discussion on Alcohol below for more information. 

Q: I am taking an airline trip, how can I get through it?

A: We know of two prescription drugs that may be helpful. Desmopressin slows urine production. It’s available in spray form under the names Concentraid, DDAVP, or Stimate, or generically as Desmopressin Acetate Nasal Solution. Desmopressin is a chemical that is similar to a hormone found naturally in your body. It decreases urine production and increases urine concentration. Its main use is to help treat kids with bedwetting problems.

We have also heard a report that the drug Detrol reduces urinary urgency and frequency if the person experiences frequent urges to urinate. If you are facing an airline trip, one of these drugs may be useful depending on your situation. Consult your physician and try the drug out before the trip to learn if it will provide temporary relief. For short-term use on an airline flight, your doctor may even be able to provide a free sample of the drug.

IPA is not medically qualified to make any judgments about the medical implications of using either of these medications and common sense would indicate that one should not take these drugs for extended periods. However, they may be of use for occasional trips and short periods of difficulty for the paruresis patient.

Learning to use a catheter will allow you to take an airline trip with total certainty of being able to empty your bladder. Many of our members carry catheters on airline flights. They feel much more at ease and can enjoy travel again. It is strongly recommended that if you use catheters to help get through a flight, bring several on board with you. When lubricated, they are slippery and sometimes slip out of your hands. Or, you might accidentally let one touch the lavatory table or wall. Always bring extras, since planes get diverted for long periods due to weather and other unpredictable events. Sometimes, short flights can last many hours. See IPA’s Catheters page for more details.

A number of people report success with holding their breath (described below) to initiate urination. This technique does not work for everyone, so you will need to test it and likely practice it a number of times before relying on it dependably.

More details on the use of Desmopressin can be found in the Best of Boards article.

Some people have reported that they are able to urinate freely using an external catheter. These are available without prescription in medical supply stores, and there is a product available through the web called the Stadium Pal. For those who can use these devices, they may be very helpful. If considering this option, remember that airline security personnel might give you a pat-down search for hidden objects and you may need to explain about the external catheter. This will be very likely if there are any metal parts in the catheter or collection bag.