It appears that paruresis involves a tightening of the sphincter and/or bladder neck due to a sympathetic nervous system response. The adrenaline rush that produces the involuntary nervous system response probably has peripheral and central nervous system involvement. The internal urethral sphincter (smooth muscle tissue) or the external urethral sphincter (striated muscle), levator ani (especially the pubococcygeus) muscle area, or some combination of the above, may be involved. It is possible that there is an inhibition of the detrusor command through a reflex pathway as well. The pontine micturition center (Barrington's nucleus) also may be involved, as its inhibition results in relaxation of the detrusor and prevents the relaxation of the internal sphincter.

Paruresis ( ) is a type of phobia in which the sufferer is unable to urinate in the real or imaginary presence of others, such as in a public restroom. The analogous condition that affects bowel movement is called parcopresis.

Anti-anxiety and antidepressant medication is commonly prescribed for treatment of social anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs) such as sertraline, fluvoxamine and paroxetine are common medications which alleviate social phobia successfully in the short term but it is not certain if they are useful in the long-term. Also the MAOI moclobemide works well on treating social phobia in the short term. Patients who have avoided certain situations should make a big effort to become exposed to these situations while at the same time taking antidepressant medication. Anxiolytic medication aids a patient to handle social or professional situations before more lasting treatment has had an effect and therefore it is a provider of short term relief, but anxiolytics have a risk of dependence. Beta-adrenergic antagonists help to control palpitations and tremors unresponsive to the treatment of anxiolytic medication. One must read the precautions of these drugs outlined in the manufacturer's literature and be careful to watch out for the contraindications of these drugs.

Treatment of social phobia usually involves psychotherapy, medication, or both.