Treatment of paruresis in the context of benign prostatic hyperplasia: A case report Original Research Article

Paruresis, the inhibition of micturition in public rest rooms, has been treated successfully by cognitive-behavioral therapy (CBT) with an exposure component. There are no reports of treatment for paruresis in the context of an organically based urinary dysfunction. This study examined the effectiveness of CBT for a 53-year-old male with chronic paruresis and benign prostatic hyperplasia (BPH). Coping skills training and in vivo exposure were applied in 21 sessions over a 12-week period. Pre- and posttreatment subjective units of distress (SUDS) ratings upon entering various public rest room situations were obtained. Data collected during exposure trials included latency of micturition, ratings of urinary volume, and SUDS ratings. Increased ability to urinate in public rest rooms and reduced anxiety and urinary delays in the presence of others were achieved. Implications for the conceptualization of paruresis and the effect of BPH on its treatment are discussed.