Are there long-term complications or impacts on sexual and urinary health from sounding?
Executive summary
Recreational urethral sounding carries both short-term and potentially long-term risks to urinary and sexual health: infections, urethral trauma that can evolve into strictures or fistulae, and rare but severe complications from retained foreign bodies have been documented in case reports and surveys [1][2][3]. Population-level data are limited and mixed—some harm appears common enough to show higher rates of STIs and lower urinary tract symptoms among people who sound [4][5][6], while harm-minimising guides and some health sites argue that careful technique can avoid lasting damage [7][8].
1. What the clinical literature actually shows about long-term urinary harm
Urology case series and reports repeatedly link sounding-related injuries to sequelae that can be chronic: retained objects migrating into the bladder and causing recurrent urinary tract infections, abscesses, bladder stones, urethral diverticula, strictures or fistulae—conditions that often require surgical correction and can persist for years [1][2][9]. Cross‑sectional surveys of men who have sex with men find higher self‑reported lower urinary tract symptom scores in those who sound, suggesting some lasting irritation or obstruction in a subset of practitioners [4][5].
2. Sexual function and nerve injury: documented risk vs. uncertainty
Media and expert commentary warn of potential nerve damage from traumatic sounding that could affect sexual function, and some academic commentary explicitly raises the possibility of short- and long-term nerve injury that might preclude sexual activity [10]. Empirical evidence directly linking recreational sounding to persistent erectile dysfunction or numbness is scarce in the literature cited here; most systematic data on sexual functioning come from surveys that show associations with higher-risk sexual behaviour and STI burden rather than clear causation of chronic neurogenic sexual dysfunction [4][5].
3. Infection risk and sexually transmitted disease correlations
Multiple sources report higher rates of urinary tract infections and sexually transmitted infections among people who sound, with one survey suggesting up to a 70% increased odds of urinary or sexual infection in the sounding group—findings that point to both direct inoculation risks from non-sterile objects and overlapping high-risk sexual behaviours in those populations [6][2][11]. Case reports of bacteremia and deep-seated infections secondary to retained foreign bodies underscore that infections can be severe and long-lasting in individual patients [1].
4. Harm-minimisation claims and their limits
Practical guides and sex‑positive resources argue that “safe” sounding—using proper, sterile, purpose‑made sounds, lubrication, gradual technique, and hygiene—reduces risks and may avoid long-term problems, with sites asserting no long-term urinary effects when done correctly [7][8]. These claims reflect a harm-reduction perspective but rest on limited prospective evidence: the literature base is dominated by case reports and cross‑sectional surveys, not long-term cohort studies, so assertions that safe technique eliminates long-term risk are plausible but not definitively proven [4].
5. Who benefits from different narratives, and where reporting gaps lie
Medical case reports and urology warnings highlight worst-case outcomes to prompt clinical vigilance, while harm-reduction guides emphasise technique to avoid stigmatizing consenting adults—each has an agenda: clinical safety vs. sexual autonomy and normalisation [1][8]. Crucially, the research gap is explicit in the literature: prevalence, natural history, and causality of long-term urinary and sexual complications after sounding remain under-studied, limiting definitive population-wide conclusions [4].
6. Practical takeaway for clinicians and users
Clinically, sounding should be treated as a real risk factor for UTIs, foreign‑body complications, urethral trauma and possible strictures/fistulae that can be chronic and require surgery; clinicians must ask nonjudgmental sexual histories because delayed presentation is common [1][3][9]. From a public-health perspective, advice grounded in harm reduction—sterile, purpose‑made devices, lubrication, avoiding sharp/fragile objects, prompt medical attention for bleeding, retention or infection—reflects the best path forward given current evidence gaps [7][11].