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Go to any sex shop (either online or physical) and the chances are you will find a selection of urethral play products, from short penis plugs to full sets of urethral dilators. Go to any BDSM forum and the chances are you will find pictures and posts about play sounding. It is popular as a form of medical play, as a self-pleasure tool and as a sadomasochistic act, and if anything it's popularity is increasing now that big-league sex shops such as LoveHoney and SexShop365 are stocking sounds and urethral play toys.
However, play sounding is perhaps one of the most misunderstood acts in our lifestyle.
With the availability and popularity of this act, it is easy to assume that it is relatively risk free. Especially when you can buy a set of non-sterile chrome-plated sounds from a major retailer with no safety advice or warnings. Why not buy a set and try them, see what everyone is raving about? Surely if it was actually dangerous, there would be more advice out there, especially from seeming sex-experts (are we calling them 'sexperts' now?) who make a huge profit from the adult market. Surely, if sounding was actually dangerous, sounds and dilators would be treated with deserved caution, rather than widely available from 'vanilla' sex retailers?
Alas, it is not so. Anyone can buy a set of sounds with the peace of mind that comes from dealing with a large, successful and reputable company. Anyone can open a leatherette case, take out a sound they bought in good faith as safe and appropriate for the intended use, smother it in Durex lube (or Astroglide, or KY Jelly, or whatever your preferred brand is) and slide it down their urethra, and do so while none the wiser as to the risks they are actually taking.
Because it is one thing to ignore advice or take a great risk, and quite another to not realise you are actually taking a risk because the very people who should be warning you are the ones cheerfully taking your money without a second thought.
Now, I'm all for RACK, I'm all for players doing their own research and I'm all for personal responsibility, but I also believe that if enough people out there are performing urethral play in a very risky (and probably not risk aware) manner, how is a newbie to know what questions to ask? How is a newbie even to know that there are risks to consider, if the boards are full of photos of people sticking Sharpie pens in their cocks?
So what is so dangerous about sounding? And how can a responsible player mitigate the dangers of urethral sounding and still have an awesome time?
DANGERS OF INVASIVE URETHRAL PLAY
Mild urinary infections - getting the wrong bacteria down the urethra leading to annoying urinary tract infections. It stings to wee, you feel a bit unwell, you need to pee lots. Quite common, usually a case of drinking cranberry juice and a trip to the GP for antibiotics.
Moderate/severe urinary infections - a nasty UTI can be hell to deal with. Maybe it'll reach your kidneys and you'll need to be hospitalised. Maybe you'll need several courses of antibiotics. Might have you out of action for a few days... or a few weeks. You might have lasting damage to your kidneys or bladder. You might get renal failure. You might need to be on dialysisfor the rest of your life.
Abscesses - build up of dead and infected organic matter, usually caused by urinary trauma combined with an infection, and which can lead to further trauma and infection
Urethral strctures - often caused by trauma to the urethra, strictures are bands of scar tissue in the urethra that can cause problems with urination. Problems passing urine can cause infections, swelling & inflammation, pain, frequent urination... which can lead to more severe infections, kidney damage, kidney failure, the creation of a false passage, etc
False passage - this is when something causes a new channel to open up in the urethra, for example due to a sound being forced down or handled roughly once inside. This can lead to urethral strictures, bleeding, infections, etc.
Bladder damage - if the sound goes down too far or is roughly handled, you could cause trauma to the bladder, including tearing it, which is not only really painful but leads to infections and the need for surgery.
Prostate damage - as the prostate glad is close to the urethra (one of the reasons sounding often feels good for those born with a penis), rough sounding or using an inappropriately sized sound can cause damage to it.
Rectal damage - if you puncture the urethra, you could tear through to the rectum which is not only very painful but introduces fecal matter and rectal bacteria into the urinary system, which is a major infection risk.
Urosepsis - this is when an infection from a UTI gets into your blood, it is a form of sepsis. Sepsis is also known as blood poisoning. Identifying and treating sepsis quickly is a case of life and death. Around 1/3 of people worldwide who develop sepsis die.
Septic shock - if sepsis is not treated quickly enough, it can develop into septic shock... which can lead to organ failure and death
And how can you decrease the risk of these complications?
Do not force the sounds or handle them roughly (wanking someone with a sound, or wanking with a sound in, forcing them down the urethra, pushing when meeting resistance, not using ample lubricant, etc) - gentle, careful sounding with an appropriately sized dilator decreases the risk of trauma that leads to bleeding, strictures and false passages (and in turn reduces the risk of infection)
Use sterile sounds - the bladder and urinary tract are actually sterile parts of the body and they are also quite vulnerable. UTIs are pretty common even when someone isn't ramming an 8 inch metal rod covered in who-knows-what down their urethra, because the penis/vulva are often covered in bacteria and other micro-organisms, and they can easily make their way inside without proper hygiene (especially after sex). And no boiling or soaking in alcohol will NOT sterilise anything. Really, it won't. You want single use sterile sounds or a way of sterilising at home such as an autoclave or cold sterilising fluid. And remember, as soon as you expose the sterile item to the air, it gets contaminated so sterilise just before you play, not as part of post-play clean up
Use medical grade stainless steel/medical plastic sounds, or single use medical catheters, or sterilised silicone plugs - sure, that set on SexShop365 is advertised as "stylish chrome-plated brass" but you don't want that in your urethra. If the chrome plating flakes or degenerates, you could get bits of metal flake in your bladder or a reaction to the brass core (not all brass is created equal so you don't know what other metals are included in the alloy). AVOID. Same goes for urethral plugs made from 'jelly' or some unidentified plastic. It needs to be body safe, internally safe and sterile/able to be sterilised.
Use lots of sterile lube - no, not your Durex out of the pump dispenser, and not that lovely passion-fruit scented warming massage oil. STERILE. SINGLE USE. And lots of it, ideally put directly into the urethral from a sterile syringe.
Clean the opening and surrounding flesh - be it the penis or vulva, clean it in the shower/bath and then liberally coat it with something like iodine or surgical scrub to really clean it. You want a layer on the skin that no micro-nasties are able to live on or travel over.
Sterile gloves - everything that touches the sound or urethral opening needs to be sterile, so glove up properly. Non-sterile gloves are great for prep (applying surgical scrub, etc) but when it comes to the actual sounding, you want sterile gloves and to keep them sterile (so don't pick up a bloody camera or use your phone without changing your gloves afterwards, jeeeeez)
Sterile fields - usually found in woundcare kits and clean area packs, these provide a sterile surface on which to put sterile tools such as sounds to help avoid contamination (only sterile things, including your hands, go on the sterile field, not all the packaging etc!)
Pay attention to you partner's reactions/your reactions - if they/you are in pain, that might be really sexy from an S&M perspective, but it's a good indicator that you are doing damage... see the aforementioned risks
Discuss all of this with anyone you want to sound with and don't let a "nah, it'll be fine" attitude get in the way of your/their safety. Discussion of risks is part of informed consent.
Eeeeeek! So if you should avoid plated brass sounds and if the big sex shops don't know what they are talking about, where do you get quality urethral play products?
Even with all of these steps, sounding is not 'safe'. It is still very much RACK (risk aware consensual kink). We're not trying to nanny you or kill your buzz, we're just trying to reduce the risk of you dying of renal failure.
More details on urology, urinary trauma and urinary infections can be found on these sites: