Study Type - Symptom prevalence (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Most of the medical literature regarding recreational urethral sounding pertains to foreign body retrieval. Very little is known about men who perform sounding and do not require medical attention. Of >2000 men, who responded to a urinary and sexual wellness survey, 10% had a history of recreational urethral sounding. Compared with men who did not sound, men who did reported higher risk sexual behaviours such as multiple sexual partners, sex with strangers and reported more sexually transmitted infections. Men who seek medical attention for complications resulting from sounding should be counselled regarding the hazards of the practice. Realistic strategies for risk reduction should be discussed with men who engage in recreational sounding. Objective To determine whether men who perform recreational sounding are at increased risk of engaging in unsafe sexual behaviours, developing sexually transmitted infections (STIs) and lower urinary tract symptoms (LUTS). SUBJECTS AND Methods In a cross-sectional, international, internet-based survey of the sexual practices of >2000 men who have sex with men, subjects were asked if they had engaged in urethral sounding for sexual gratification. We compared ethnodemographic and health-related variables between the sounding and non-sounding populations. The International Prostate Symptom Score and a modified validated version of the International Index of Erectile Function were used to quantify LUTS and erectile dysfunction (ED) in both populations. Results There were 2122 respondents with complete data, 228 (10.7%) of whom had engaged in recreational sounding. Men who had engaged in sounding were more likely to report certain high risk sexual behaviours (e.g. multiple sexual partners and sex with partners who were not well known) and had increased odds of reporting STIs. Men who had engaged in sounding had a slight but statistically significant increase in LUTS but no significant difference in prevalence of ED. Conclusions Urethral sounding is a sexual practice that is associated with higher risk sexual behaviour and carries the potential for morbidity. Research on means for risk reduction for men who choose to engage in recreational sounding requires further study.
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