Can anyone please tell me what's going on with urinary 'hesitation'? I mainly have a very good flow (unless I'm flaring up) but suffer from an annoying hesitation. Strangely, I can trick myself into starting by trickling a nearby sink tap or something, which makes me think it's part psychological. But mechanically, what is going on here? A failure of the pelvic muscules to obey ordersl?
Thanks to anyone who can explain this to me..
hesitation
hesitation
Age: 44 | Onset Age:41 | Symptoms: abdominal pain and discomfort, urinary frequency, low libido | Helped By: quercetin, diazepam, neurontin, Elavil | Worsened By: sex, alcohol, caffeine
I have no explanation for you but when I'm in pain I also suffer from severe hesitation especially in public toilets. Sometimes it helps to put the tap on.
The most annoying thing in the whole world is when it only comes a few drops and you find yourself in need again after like 30 seconds and the story goes on for up to 24 hours, I just hate that.
Best wishes
The most annoying thing in the whole world is when it only comes a few drops and you find yourself in need again after like 30 seconds and the story goes on for up to 24 hours, I just hate that.
Best wishes
Age:25 Onset age:20 | Symptoms: Bladder/rectum pain, heartburn, sexual dysfunction, urethra and perineum pain, IBS, chronic fatigue. Makes worse: bad diet, poor sleep, alcohol. Makes better: positive thinking, good diet, drinking lots of water, internal/exernal stretching
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LightningTree
- Sage
- Posts: 623
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- Location: San Francisco, CA, USA
- Contact:
Hey Guys,
This is totally normal and is part of the behavior pattern which fits in with the theory behind the Stanford/Wise-Anderson Protocol. For the best answer to this question, consult a urologist, but here is my laymen's memory:
Passing urine requires that the bladder wishes to involuntarily contract, and the bladder neck wishes to open, but also that many muscles in the lower pelvis are voluntarily controlled to relax.
This makes feces and urine passage fairly complicated, as there is a carefully orchestrated set of relaxations and contractions that have to occur at the same time and involve both the involuntary and voluntary responses. The voluntary reflex is reinforced by relieving the uncomfortable feeling of having to go. The upside is that you can control when you go! The downside is that if you have chronic anxiety, and pelvic tension, you can't go! You tend to hold it in even when you don't want to. This keeps you protected from exposure to external danger (you aren't very agile while peeing.)
If you are a tense person (your body perceives consistent danger) who holds tension in the pelvis, then when you are in a public bathroom, you are "on guard" and will have trouble releasing the tension in your pelvis. Therefore, while your bladder is 'ready to go', you cannot commit to the voluntary relaxation necessary to pee.
Now, if you have trouble being able to pee, tell me, how relaxed do you think your pelvic muscles are throughout the day?
When I have flare-ups (none since May) I have trouble starting urination, and then when I am done, I continue to leak a little bit. A PT told me that the voluntary and involuntary reactions are 'out of synch' because either or both the voluntary and involuntary muscles are irritated. Maybe the nerves, too.
When I first had these symptoms, I had had life long trouble peeing at a public urinal and also had trouble peeing before going out to social events. I now recognize that this was anxiety driven. With all of my relaxation process, I can now stand next to anybody at a urinal, and through relaxation, I can pee at will.
I am a jedi, zen pee master.
This is totally normal and is part of the behavior pattern which fits in with the theory behind the Stanford/Wise-Anderson Protocol. For the best answer to this question, consult a urologist, but here is my laymen's memory:
Passing urine requires that the bladder wishes to involuntarily contract, and the bladder neck wishes to open, but also that many muscles in the lower pelvis are voluntarily controlled to relax.
This makes feces and urine passage fairly complicated, as there is a carefully orchestrated set of relaxations and contractions that have to occur at the same time and involve both the involuntary and voluntary responses. The voluntary reflex is reinforced by relieving the uncomfortable feeling of having to go. The upside is that you can control when you go! The downside is that if you have chronic anxiety, and pelvic tension, you can't go! You tend to hold it in even when you don't want to. This keeps you protected from exposure to external danger (you aren't very agile while peeing.)
If you are a tense person (your body perceives consistent danger) who holds tension in the pelvis, then when you are in a public bathroom, you are "on guard" and will have trouble releasing the tension in your pelvis. Therefore, while your bladder is 'ready to go', you cannot commit to the voluntary relaxation necessary to pee.
Now, if you have trouble being able to pee, tell me, how relaxed do you think your pelvic muscles are throughout the day?
When I have flare-ups (none since May) I have trouble starting urination, and then when I am done, I continue to leak a little bit. A PT told me that the voluntary and involuntary reactions are 'out of synch' because either or both the voluntary and involuntary muscles are irritated. Maybe the nerves, too.
When I first had these symptoms, I had had life long trouble peeing at a public urinal and also had trouble peeing before going out to social events. I now recognize that this was anxiety driven. With all of my relaxation process, I can now stand next to anybody at a urinal, and through relaxation, I can pee at will.
I am a jedi, zen pee master.
This is not medical advice, and I am NOT a doctor of medicine or a related field.
* Age:33 Onset: February 2004.
* 99.9% IMPROVEMENT in 2.5 Years with the first year being the really hard part
* Current Symptoms: Mild irritation of perineal muscles on occasion. Relieved for days at a time by a specific stretch (see below).
* Initial Symptoms: Terrible penile, urethral, rectal, and perineal burning/aching with addition afferent sensations.
* Current Treatments: Deep stretching of the legs and pelvis. Most effective: Deep psoas and levitar ani stretch using the first phase of the "pigeon pose" from Yoga. When a deep pulling is felt in the middle of the pelvis next to the upper rectum, symptoms are completely alleviated for several days.
* Past Treatments Hyperprotection of the perineum for 1.7 years, Walking, Rectal biofeedback, Stanford/Wise-Anderson Protocol, Conditioned deep relaxation practice, Men's Multi-Vitamin and an Extra B-complex pill, all seemed to help.
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timberdoodle
- Experienced
- Posts: 112
- Joined: Wed Dec 08, 2004 10:15 pm
I have to add that I could not pee in a public restroom at a urinal for as long as I can remember. I always made a bee-line for the stall for some privacy. I wish I could have seen that as a warning sign of bad things to come when the major chronic prostatitis / chronic pelvic pain syndrome symptoms hit over a year ago. I am, by the way, getting better at peeing in public, but I am not yet as strong in the ways of the force as Lightning Tree. 
Age: 40 Symptoms for seven years; Symptoms include: subrapubic & genital discomfort; perrenial pain, feeling like groin is swollen, problems with urinary frequency are resolved; helped by: abdominal stretching, Theracane work on abdomen, light exercise (nordic track); worsened by: sitting and office work
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osu-danuki
- Beginner
- Posts: 36
- Joined: Tue Dec 13, 2011 6:57 am
Re: hesitation
I also have had this problem my entire life (being unable to pee next to people at a public urinal), though I don't have any problems with hesitancy when I have privacy. I already have a daily meditation practice, so I'm working on relaxation in a more general way, but is there any technique people have found especially helpful for attacking this problem specifically?
Current age: 30; Symptoms began: 29; | Symptoms: dull, burning pain in scrotal, perineal and rectal areas, focused on the left side, dull stomach pain when sitting; Improved by: stretching, yoga, Theracane massage (external and internal, though it causes flare-ups), diazepam (valium), hydrocodone (vicodin), hot baths, sleep, relaxed sex, alcohol (a little); Worsened by: SITTING, frequent masturbation/ejaculation, lots of caffeine (but a little's okay); May help a little: Doxazosin (but caused heartburn), Prosta-Q, nerve block injection (provided symptomatic relief for a few days but likely no long-term benefit); NO help: Amitriptyline (Elavil), Cernilton
Re: hesitation
Since getting chronic prostatitis / chronic pelvic pain syndrome I haven't had any hesitation issues but can vouch for the fact that the mind has a large part to play in such things. A few years back I had an operation and spent the night in the high dependency unit wired up and unable to leave my bed. The only way I could pee was into a bedpan but go I couldn't. I spent hours trying to pee but because I was lying in bed my brain just wouldn't let me urinate, the muscles just would not relax. It was so frustrating at the time but it just goes to show how much control the mind has.
Age 40. Symptoms started Feb 2011 but for a number of years before sometimes had burning pain after ejaculation for 30mins or so. Initially testicle discomfort, then bladder pain/urgency followed by penile discomfort and burning after urination. Used to have periods of being symptom free but now have continual penis discomfort, mainly at tip. During a flare pain is more of a burning type, especially after urination. 3 negative urine tests, cystoscopy, ultrasound of kidneys/bladder all negative. Urologist never gave me anitbiotics or suspected prostate infection but couldn't find out what was wrong. Helped by rest, heat (sauna/hot bath). Just started on amitriptyline, no benefit yet.