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Dear Dan: A straight male friend practices sounding and has for years. I am pretty sure he does other things that he isn’t telling anyone about — not even his wife. He has some medical questions about sounding. I am a pediatric nurse, so he brought his concerns to me, but the questions are totally outside my area of expertise. Nothing emergencyroom-worthy is going on, but he needs answers and refuses to speak with his regular MD about sounding. I am wondering how to find an MD in his area who would be knowledgeable and nonjudgmental.

Needs Useful Referral Soon P.S. Thank you for your advice over the years. Because of you, I am comfortable with the questions he asked me even if I did not have the answers.

Dear NURS: The National Coalition for Sexual Freedom maintains a “Kink Aware Professionals Directory” on its website: ncsfreedom.org. The doctors, counselors, lawyers, real-estate agents, etc. aren’t vetted by the NCSF, so inclusion on the list isn’t a recommendation. But it would be a good place for your friend to start looking for an irregular MD, someone he can open up to about sounding and whatever else he’s doing. In the meantime, I asked a doc for some thoughts about the risks and rewards of sounding.

“Sounding refers to the insertion of foreign bodies into the urethra,” said Dr. Stephen H. King, MD, a board-certified urologist. “Under controlled medical conditions, urethral sounds, which are typically curved and sterilized metallic or plastic rods, are gently inserted onto the urethra [pee hole] in order to dilate a stricture [narrowing] that blocks the flow of urine out of the bladder. The lining of the urethra is typically very sensitive and delicate, and this procedure can be quite uncomfortable for most people.”

But not everyone with a metallic or plastic rod sticking out of their urethra right now is experiencing discomfort. “Some people, likely a significant minority, derive sexual pleasure from urethral stimulation,” said Dr. King. “This includes both men and women. Sounders [not to be confused with Seattle’s soccer players!] have been known to insert a wide variety of objects, including but not limited to catheters, tubes, beads, pencils, batteries, drill bits, and even the head of a decapitated snake. Yes, the latter has been reported.”

I think we all need a moment to process that last detail. Someone found the head of a decapitated snake — or someone found a snake and decapitated it — and thought: “You know what? I’m going to stick this in my urethra.” This probably wasn’t something anyone who hasn’t shoved the head of a decapitated snake into their urethra even thought human beings were capable of before Dr. King shared this with us. And now we’ll never be able to forget it. Deep breaths, everybody. Let our shared trauma bring us closer together, not drive us apart.

Okay! On to your question, NURS:

Your friend is a self-sounder and has been for years. So just how dangerous is sounding?

“Some sounders end up in emergency rooms to remove a stuck object, leading to interesting X-rays and many good party conversations for us urologists,” said Dr. King. “But there is very limited medical literature on this topic beyond mostly case studies. However, one recent survey study associated recreational sounding with general high-risk behaviors and increased risk of STIs. Additional complications can include bleeding, infection, urethral stricture, perforation, and erectile dysfunction.

Some of these issues may cause long-term impairments or require surgical correction.”

A couple qualifiers from a nonmedical nonprofessional (me): Sounding by itself doesn’t lead to higher rates of STIs. While an inept sounding session could leave a person with a raw and bloodied urethra, and this rawness would place a person at higher risk of contracting an STI should they be exposed to one, it’s the propensity toward high-risk behaviors generally that places sounders at greater risk of contracting STIs, not the sounding itself. Dr. King agrees with me on this point.

Also, people who don’t get objects stuck in their urethras — sounders who don’t progress to larger and larger objects before finally moving on to heads from decapitated snakes — don’t make appearances in emergency rooms, the medical literature, or urologists’ party conversations.

So the sample here is skewed, with sounders who are shoving only sterilized, welllubricated and reasonably sized metal rods into their urethras underrepresented in the medical literature, cocktail party convo, etc.

So while shoving a metal rod into your urethra is more dangerous than not shoving a metal rod into your urethra, it’s not as dangerous as the limited medical literature would seem to suggest. “My guess is there are many people who sound without significant problems,” said Dr. King. “If performed in a very clean (ideally sterile) fashion with minimal trauma to the urethral lining, sounding maybe be relatively safe. The sounder, however, should be aware of these risks.”

Send questions to Dan Savage at mail@ savagelove.net and follow him on Twitter @ fakedansavage.

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