What is Shy Bladder syndrome?

Paruresis is described as "An inability to urinate in the presence, real or perceived, of others". Common names for the condition are 'shy bladder', 'bashful bladder' or 'pee shy'. A medical description is Psychogenic Urinary Retention.

Paruresis is recognised as a social anxiety disorder rather than a social phobia. It affects both men and women, of all ages and backgrounds.

Sufferers are often called Avoidant Paruretics (or APs for short), meaning that their paruresis manifests itself in avoiding the situations that inhibits an individual from being able to pee.

We have collaborated with the UK Paruresis Trust (UKPT), to provide useful information to individuals that may be affected by shy bladder.

Urine drug testing and shy bladder

As a company, we understand that the collection of urine samples for drug testing can be perceived as invasive. As such, we always offer alternative sample collection methods to individuals and organisations looking to undertake drug testing.

In addition, if it is a regulatory requirement that a urine sample must be used for a drug test, we have introduced protocols and policies to minimise any discomfort or anxiety felt by the donor. This includes issues of potential discrimination and the consideration of existing medical conditions, such as paruresis.

For example, we will always provide privacy and a secure toilet facility for sample donors. Our sample collection officers do not observe the urine sample being provided as we put measures in place to avoid potential adulteration of samples, for instance, blue dye in toilet bowl and cistern, and tamper seals across taps and water sources.

Furthermore, if there is a case of shy bladder, many of our workplace testing clients have contingency sample methods in place. This will involve the collection of saliva samples rather than urine.

However, there are exceptions to this, and some safety critical industries require a urine sample without the contingency of saliva samples. for example, Network Rail do not allow saliva contingency testing on site. However, their standards do state that any donor who cannot provide a sample should be reviewed by a medical review officer (MRO) prior to uploading a FAIL or NO RESULT because of being unable/refusing to provide a sample. It would ultimately be the MROs responsibility to review each candidate and circumstances on a case by case basis and this should be the stage at which any medical evidence is submitted in support of the donor's claim.

In addition, we always advise individuals and organisations to disclose any medical conditions that may impact a drug test prior to testing. Many companies who introduce a drug testing programme will have a period of time in which they allow employees to raise any concerns they have. This would also apply to an employee starting a new job, as they would be able to view the company’s drug and alcohol policy and address any concerns prior to being in a position where they are asked to undergo testing by providing a urine sample. If possible, the solution would be to use saliva samples rather than urine.

Finally, we will always advise our workplace drug testing clients of best practice. In this case, donors who are unable to urinate due to paruresis, must not be discriminated against or deemed as failed a drug test because they cannot provide a urine sample. All of our chain of custody forms are designed to capture instances of non-conformance in cases of being unable to provide, or an insufficient sample. As a result, such cases will not be treated as a fail, but will instead trigger the collection of a contingency sample such as saliva, or fall back on the organisations own drug and alcohol policy.