What Can Be Done For A "Shy Bladder''?

QUESTION:

Dear Dr. Heller,

I wonder if in your travels you have run across people with paruresis, otherwise known as pee shy bladder.  In my quest to help my own male child who developed this problem in freshman year, I have found no specific diagnosis (phobia, OCD, ?) or treatment options that work.  Others before him, now older and still living with this problem, have expressed no or very limited success with medication.  The major treatment seems to be desensitization and it seems to continue as a life long problem for most.  I would appreciate your comments on this and whether you have come up with a diagnosis and treatment that works for most or in some cases.

Thank you.

ANSWER:

Many men have trouble initiating urination when feeling anxious - especially when rushed or someone is looking at them.  It's far more common than people think because men rarely talk about it. 

While social phobia may be to blame, other anxiety disorders may be contributing to the problem - particularly when there is more than one anxiety disorder present.  My screening test may be of assistance.