What do earphones, olive seeds and a coyote rib have in common? Give up? They've all been removed from a human urethra.
Author
Adam Taylor
Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University
Yes, you read that right. In case you're wondering, the human urethra is a tube that carries urine from the bladder to outside the body. I know. Ouch.
Some people find it sexually pleasurable to insert objects - known as sounds, which are typically small glass or metal rods - or even fluid into the urethra. Many objects have been used for sounding, however, and that's one of the reasons the practice is so hazardous.
The urethra is a narrow outflow tube, usually less than 9mm wide, so squeezing objects into it isn't usually recommended. An exception is medical procedures, when surgical tools and camera apparatus may be inserted into the urethral passage to stretch or widen it so urine can pass through.
The use of objects and implements for sexual self-stimulation is not new but it is risky. There's a high likelihood that sounding practitioners will need medical or surgical intervention at some point because of trauma from insertion, and the potential loss of the object.
According to studies, many household objects have been used as sounds. Be warned, the list makes for eye-watering reading. Those recovered from male urethras include forks, telephone cables, 1m long electrical cable, tennis racket wire, metal piping, nail clippers, an allen key, needles, olive seeds, batteries, rubber tubing, headphones, 67 magnetic balls, a coyote rib, and a 45cm decapitated snake.
Women, however, have a much shorter urethral tube in which to insert things, which increases the likelihood of retention of the object and its movement into the bladder. While women are far less likely to end up in accident and emergency after a sounding incident, various objects have been found in women's urethra, including an eye-liner pencil, sex toys, vibrators, and a small glass ampoule.
A small number of women have a congenital condition known as megalourethra, which, as the name suggests, means "large urethra". Megalouretha can lead to retention of objects in the urethra or bladder from clinical examinations such as cervical screening.
It is unclear how often sounding is practised or by how many people among the general population. However, research focuses primarily on men because they make up the majority of cases seen in emergency rooms. Also, men make up 85% of object retrieval cases from other bodily orifices.
Risky business
The risk of serious injury from sounding is increased in males because, whether the penis is flaccid or erect, the urethra is not a straight tube. It takes several turns to pass through the pelvic floor muscles, prostate and then, if inserted far enough, the bladder.
These turns increase the risk that whatever is being inserted might actually puncture through the urethral wall, prostate or bladder, then nearby structures, which can include major blood vessels and nerves resulting in long-term issues.
That's why it's almost exclusively men who're injured during catheter insertion by trained medical professionals. And if medically trained professionals find such a routine job tricky, then it's easy to see why the people who indulge in urethral sounding for sexual pleasure can so easily end up in accident and emergency.
Urethral damage exposes the underlying connective tissues which can cause blood in the urine, as well as erectile dysfunction and even bladder rupture. Trauma and damage may lead to further narrowing of the urethra in later life which may require medical intervention.
Sounding also carries a risk of sexually transmitted diseases, as well as other bacterial infections from inserting non-sterile objects or implements.
The body may also attempt to limit further damage by calcifying objects stuck internally. For example, in one case, a large calcified stone formed around the plastic ink chamber of a pen, which had been inserted into a man's urethra and bladder.
If sounding objects become stuck, there are two possible removal options. First, cystoscopy where a camera is inserted into the urethra to retrieve the lost object. If that procedure proves unsuccessful, then a patient may need surgery to go through the abdominal wall to get to the bladder and remove the object that way.
Sounds painful
All of this may sound like a lot of pain for a relatively small amount of pleasure.
But sounding can be highly sexually gratifying for some people.
The arousal and subsequent stimulation of the erectile tissue of the penis and clitoris usually occurs through one of two mechanisms: psychogenic (images or thoughts) or reflexogenic (touching).
The reflexogenic pathway is served by nerves which also innervate the lining of the urethra - the dorsal nerve(s) of the penis or clitoris. The stimulation of this nerve will contribute to the arousal process and offers an alternate simulation to that of the external surface of the penis or clitoris.
For those individuals who perform sounding, or wish to, it is important to recognise the significant risks of infection and short- and long-term nerve damage that may well preclude sexual activity of any kind.
Any sounding devices should be purchased from reputable suppliers - rather than using household objects - and should be cleaned properly to reduce the risk of introducing pathogens into the body. Specific lubrication to protect the internal urethral lining should also be used.
Adam Taylor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
