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Muneeb Ali
Muneeb Ali, Emergency Medicine
Category: Urology
Satisfied Customers: 6347
Experience:  MBBS,MD,ECFMG certified. Have dealt with urological emergencies in the ER on a regular basis
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I am in a program that requires random drug testing but I

Customer Question

I am in a program that requires random drug testing but I have suffered with paiuresis all my life. No matter how hard I try, I cannot initiate a stream when I am being observed. I have avoided public urinals my entire life. Now that I am required to have random drug tests, I am heading to having serious problems secondary to this issue. How do I find a Urologist that can diagnose and treat or provide supportive documentation that I have this problem so I can request hair follicle analysis.
JA: How long have you been dealing with this? Is there anything in particular that makes your head feel worse or better?
Customer: We are talking about an anxiety disorder that prevents me from urinating in front of someone.
JA: Anything else in your medical history you think the doctor should know?
Customer: no
Submitted: 9 months ago.
Category: Urology
Expert:  Muneeb Ali replied 9 months ago.


Welcome to JA and thanks for this question. My name is***** and i am reviewing your question and will get back to you with a response ASAP!!!

Expert:  Muneeb Ali replied 9 months ago.

Well from what you are describing it is clear you are suffering from shy bladder syndrome or paruresis as you described. This is an anxiety disorder which i believe you already know and it being a psychological disorder, it has to be dealt by a psychologist or psychiatrist rather than a urologist. Paruresis is not a physical condition because nothing is wrong with the person’s urinary tract. The urinary sphincter must be relaxed in order for urine to flow from the bladder down the urethra. Anxiety about urinating overstimulates the person’s nervous system and ‘clamps’ the sphincter shut. Failure to urinate heightens the person’s anxiety, particularly if the bladder is uncomfortably full. This can be treated effectively if you undergo several forms of psychotherapy which may include cognitive behavioural therapy, graduated exposure therapy, relaxation techniques.

So that being said, you need to see a psychologist/psychiatrist who can write you a note explaining the situation to your employers and at the same time start you on therapy to get this disorder under control. Once you are examined by him, the problem with the drug tests can be solved and you can have hair follicle tests instead of urine drug tests until the problem is rectified.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

Expert:  Muneeb Ali replied 9 months ago.

Would you like to know anything else? If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.