This solution worked for me!

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JohnSofSydney
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Joined: Fri Mar 27, 2009 1:56 pm

This solution worked for me!

Post by JohnSofSydney » Fri Mar 27, 2009 2:27 pm

What worked for me was no longer using any muscular clenching to eliminate the final drops of urine at the end of urination, ‘spurting’ at the end. It’s common for men to kind of spurt out the final few drops, in a way that uses muscles to effectively squeeze the urethra (tube from bladder to exterior) and the bladder sphincter. It occurred to me about six months ago that clenching those muscles around the urethra tube was developing and enlarging them. Those muscles were larger than they would be with no clenching, and then, when anxiety causes a general muscular tension, those already enlarged muscles around the urethra expand a bit, like all your muscles do when you’re tense, and that expansion is enough to cause tightening on the urethra and obstruction of flow.

So I stopped trying to spurt out those last drops at the end of urinating, and I had a massive improvement in just days. It takes a bit of concentration at first because old habits die hard, and it's almost like a kind of reflex to spurt, but you just have to make sure you stay relaxed at the end of urination. In a few seconds the final drops emerge on their own – the muscular spurting attempts never really worked that well anyway. The old saying ‘no matter how you shake and dance, the final drops go down your pants’ certainly apply when you do the clenching to spurt anyway, because squeezing on the urethra also pushes some urine back towards the bladder, and that urine comes out anyway after a minute or two anyway.

Within a couple of weeks I stopped using the BPH medication that my doctor had prescribed me. It was obvious after a few days that an enlarged prostate wasn't causing my urinary hesitancy, as the improvement from staying relaxed at the end of urinating was so dramatic that it completely blew away any small perceived improvement that I got from taking the medication. I’ve since gradually lost my anxiety around urinating in a whole range of situations. I expect I’ll be completely without urinary anxiety in months. I feel that I’ve eliminated the main cause of the problem, and now it’s just a matter of mopping up the remaining psychological effects, and that has been easy.

I always had a strong sense that there was a physical cause of the problem, and that it was exacerbated by anxiety. It’s not really surprising that spurting at the end would cause problems, when you consider that you’re basically squeezing on your urethra a few times at the end of each urination, making a likely total of 20 or more squeezes a day on that tube which you so want to remain unconstricted. I had a serious case – I ended up not being able to go at work and I was thirsty a lot of the time to avoid the need to go. It was affecting every aspect of my life. I’d had an ultrasound test to see if there was a problem, but that just showed my prostate to be only ‘marginally’ enlarged. Now I’m close to being normal, and expect to be normal.

A couple of things: Try to mostly stand to urinate if possible. Some sit because you can relax more seated, but the process of getting up can make it harder to ensure that the lower abdominal muscles remain relaxed when you're done, so it’s harder to prevent that almost reflexive spurt impulse. The aim is to reduce the size of the muscle tissue around the urethra, and the way to do that is to minimise as much as possible their use. Avoid sex for the first few days if you can, to maximise the results. You’ll find that if you have a lot of sex, say more than two ejaculations daily, the problems may return because the higher use of the muscles around the urethra during ejaculation will cause them to re-enlarge.

Try this if you’re not already doing it. It makes sense and it really worked for me. If you know you’re remaining relaxed at the end of urinating and still have issues, obviously the cause of your problems is something else. But I couldn’t remain silent about the benefits I’ve got from trying this. Post your results if you give it a go!

JohnW
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Joined: Sat Jan 10, 2009 9:42 pm

Re: This solution worked for me!

Post by JohnW » Fri Apr 03, 2009 2:51 pm

JohnS,
Thank you for your interesting and detailed post where you share your success with us. Congratulations!
Since I have been in excellent paruresis recovery for perhaps twenty years, I am hardly in a position to try out your technique for myself to test it as a remedy for paruresis. The same goes for the breath-holding method which some people (including one Australian) recommend so highly.
My other problem is that I am not really an expert on physiology. My reading of much paruresis literature/webpages indicates that it is the internal sphincter which is the main culprit, and that relaxation (lack of anxiety) is a key to it releasing when we want it to. However, it is not under our conscious control. Whether your technique leads to that sphincter being more co-operative is a question I must leave to those more knowledgeable - perhaps Derek can comment on this.
I am aware of using some muscular pressure to encourage the bladder to empty at the end of urinating, and I assume this is what you mean by "spurting". However, I am also aware that there is always some quantity of urine left in the bladder, even when all has gone well. I also had an ultrasound recently on that region of my body, and the examination required that I empty a very full bladder, after which the ultrasound was repeated. I know that my "voiding" was regarded as very satisfactory (almost outstanding - can you believe it for a past paruretic!), but there was still some urine remaining in the bladder, and this passed without comment.
Perhaps people still pursuing recovery can try your technique for some months, and report back to us.
JohnW

JohnSofSydney
Posts: 2
Joined: Fri Mar 27, 2009 1:56 pm

Re: This solution worked for me!

Post by JohnSofSydney » Thu Apr 09, 2009 5:44 am

Thanks JohnW. I hope some people do try it and see if it benefits them. Several people at the international site have said they'd try it, but it's a bit early to see if there was any outcome. I suspect that the muscular tensioning I used to do during 'spurting' or 'squirting' out the last drops might also involve the muscles around the bladder sphincter, which you refer to. If you think of them as dohnut shaped around the sphincter, then it makes a bit of sense that if they're even a little overdeveloped from all that sqirting at the end, day in day out, it would take only a bit of enlargement and hardening of that dohnut shaped muscle, due to tension from anxiety, for the hole in the dohnut, where the sphincter is, to close up a bit and become harder to open.

Not squirting freed me up so much that I couldn't help coming to a theory, that way back in my teens when I first started to use those pelvic muscles to squirt out the last drops, the overuse of certain muscles might actually have caused the early hesitancy I experienced. Of course back then I didn't get it, didn't like it and thought it was just shyness, which later developed into a phobic complex, which then exacerbated the condition because of tension in unnaturally overused muscles in the area produced by anxiety.

That got me thinking that a lot of others might have had the same thing happen to them. What might make some people reluctant to try remaining relaxed at the end is that you have to stand at the urinal/toilet for 10, 20 or 30 more seconds after finishing, and if there's someone waiting you feel a bit bad. Also, most people aren't keen to risk there being some evident after-drips on their clothing, not surprisingly! So they like to do whatever they can to ensure those final drops come out and are wary about trying something that might leave some chance of after-drip. I remember being quite paranoid about that as adolescent/young adult, horrified at the thought of drops showing afterwards, so I used to squirt at the end for all I was worth. Thing is, there was always a bit more anyway, because I was using muscle pressure on the urethra to squirt, which pushed some urine back up towards the bladder as well as pushing it out, which then found it's way down a minute or two later. You mention there being some left in your post too. So now I never squirt but I don't have worries about delayed drops because I just wait a bit, and it's easy enough to ensure whatever urine is almost out comes out without internal muscular ejaculating.

It's funny to think that hypersensitivity to one urine-related matter, ie evident drips afterwards, could cause such thoroughness in squirting out those drops that it caused a much more serious problem of not even being able to go at all at times. These days I don't mind staying a little longer to wait for the last drops. I'm convinced that the squirting did cause my problems initially, and I'd like to hear from anyone who tries not squirting to see how it goes for them. Thanks for your interest John.

5dave
Posts: 3
Joined: Fri May 29, 2009 6:49 am

Re: This solution worked for me!

Post by 5dave » Fri May 29, 2009 8:49 am

Hi,
yes I'v been doing this for quite a while. To me it's a good example of becoming more in touch with your body. That is knowing and understanding how your body feels. When we are tense and experiencing anxiety at the trough, we are very much out of touch with our body. We are simply in a re-active mode (fight or flight) with all that adrenaline pumping around, and we can't even hope to be able to sense how our body feels. This method that your talking about gives us the time to be able to make that connection with with the all the organs, spincters, muscle tissue and other body parts that are involved in the process of urination.
I'v observed that when I have misfires associated with anxiety I tend to be very unaware of any sensation of the presence of urine (not even that small tickle you get in your male organ just as the flow is beginning to start).
I have been using this method on my path of recovery for quite a while. I never really gave it much thought, it just seemed to come about naturally when practicing. The way I see it is the practice/ desensitization activities that we participate in are all about training ourselves to feel comfortable in the male restroom environment which includes the actual restroom, ourselves and our fellow restroom users. We need to take our time in the toilet and not think that we must be rushed. A couple of squirts is probably normal, but I think that excessive spirting/ squirting has a sense of rushing and impatience attached to it. Take as long as you feel you need, which is the time needed to calm down and become aware of those parts of your body you are about to use.
I myself practice rather like you. I stand at the urinal and drain myself completely taking as long as I want, almost always longer than anybody else.
Having said what I said above, avoiding squirting may not be for everyone. However becoming more mindful of your bodily sensations and bringing onboard a sense of peace and patience I think is definately helpful for all.

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