A slow flow rate can be due to an enlarged prostate or a narrow uretha (the tube the wee goes down, think thats the right name!). This will increase the time it takes to start, which doesnt help having paruresis at the same time!
Another problem relating to paruresis could be due to having held a full bladder for a long time, and over time this causes the bladder walls to stretch and weaken. Its the bladder muscle that squeezes, and the more its stretched then the less elasticity it has, therefor less flow rate.
Sorry if thats hard to understand, Im just quoting from memory!
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