Urine for a treat: A brief overview of catheterophilia

In a previous blog, I examined medical fetishism (i.e., those individuals that derive sexual pleasure and arousal from medical procedures and/or something medically related). Maddy’s Mansion features a small article on medical fetishism and is a little more wide ranging in scope:

“Medical fetishism refers to a collection of sexual fetishes for objects, practices, environments, and situations of a medical or clinical nature. This may include the sexual attraction to medical practitioners, medical uniforms, surgery, anaesthesia or intimate examinations such as rectal examination, gynecological examination, urological examination, andrological examination, rectal temperature taking, catheterization, diapering, enemas, injections, the insertion of suppositories, menstrual cups and prostatic massage; or medical devices such as orthopedic casts and orthopedic braces. Also, the field of dentistry and objects such as dental braces, retainers or headgear, and medical gags. Within BDSM [bondage, domination, submission, sadomasochism] culture, a medical scene is a term used to describe the form of role-play in which specific or general medical fetishes are pandered to in an individual or acted out between partners”.

As is obvious from the description above, one very specific sub-type of medical fetishism is catheterophilia. Both Dr. Anil Aggrawal (in his book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices) and Dr. Brenda Love (in her Encyclopedia of Unusual Sex Practices) define catheterophilia as sexual arousal from use of catheters. The Right Diagnosis website goes a little further and reports that catheterophilia can include one or more of the following: (i) sexual interest in using a catheter, (ii) abnormal amount of time spent thinking about using a catheter, (iii) recurring intense sexual fantasies involving using a catheter, (iv) recurring intense sexual urges involving using a catheter, and (v) sexual preference for using a catheter.

Not only is catheterophilia a sub-type of medical fetishism but is also a sub-type of urethralism (that I also covered in a previous blog). Catheterophilia may also share some overlaps with other sexual paraphilias such as paraphilic infantilism (i.e., deriving sexual pleasure and arousal from pretending to be an adult baby). Dr. G. Pranzarone in his Dictionary of Sexology (and relying heavily on Professor John Money’s seminal 1986 book Lovemaps) defines urethralism as:

“The condition or activity of achieving sexuoerotic arousal through stimulation of the urinary urethra by means of insertions of rubber cathethers, rods, objects, fluids, ballbearings, and even long flexible cathether-like electrodes (“sparklers”). This activity may be part of a paraphilic rubber catheter fetish, a sadomasochistic repertory, sexuoerotic experimentation and variety, or activity the result of anatomic ignorance as urethral intercourse has been described wherein a case of infertility was due to the insertion of the husband’s penis into the wife’s urethra rather than the vagina”.

Pranzarone also provides a little information on catheterophilia, and notes that it is a sexual paraphilia of the “fetishistic and talismanic type in which the sexual arousal and facilitation or attainment of orgasm are responsive to and contingent on having a catheter inserted up into the urethra”. Catheterization is nothing new and according to Dr. Brenda Love has been practiced for at least 4000 years. She also provided a lengthy entry in her sexual encyclopedia although most of it is devoted to describing different types of catheters. However, her perspective on catheter use is related more to sexual masochism and sexual sadism. More specifically, she claims that:

“Catheters are used in sex play as a symbol of total control over a partner. This type of sex play is similar to the catheterization found in health care facilities. The sterilized catheter is inserted up through the urethra and into the bladder which allows the flow of urine to be controlled by the dominant partner. The stimulation seems to trigger the brain’s pleasure center that ordinarily responds to urination or ejaculation…the urethra is often sore and burns for half an hour afterward”

Apart from definitions of catheterophilia, and short summaries that the condition exists, there has been little in the way of academic or clinical research. I couldn’t even find a single case study. A Finnish study led by Dr Laurence Alison reported in a 2001 issue of the Archives of Sexual Behavior reported that enduring the insertion of a catheter was one of the activities engaged in by sadomasochists, particularly those involved in ‘hyper-masculine pain administration’. Other associated activities by this group of practitioners included rimming, dildo use, cock binding, being urinated upon, being given an enema, fisting, and being defecated upon. Gay men were more likely than heterosexuals to engage in these types of activity.

In 2002, the same team, this time led by Dr. Kenneth Sandnabba examined the sexual behaviour of sadomasochists in the journal Sexual and Relationship Therapy. The paper summarized the results from five empirical studies of a sample of 184 Finnish sadomasochists (22 women and 162 men). More specifically, the examined the frequency with which the respondents engaged in different sexual practices, behaviours and role-plays during the preceding 12 months and reported that 9.2% had used catheters as part of the sexual activities.

In a previous blog on fetishism, I wrote at length about a study led by Dr G. Scorolli (University of Bologna, Italy) on the relative prevalence of different fetishes using online fetish forum data. It was estimated (very conservatively in the authors’ opinion), that their sample size comprised at least 5000 fetishists (but was likely to be a lot more). Their results showed that there were 28 fetishists (less than 1% of all fetishists) with a sexual interest in catheters.

When I published my previous blog on urethralism, one reader wrote to me with an example of urethral stimulation via catheter use. Obviously, I have no idea to the extent of such practices and how typical this experience is, but I thought I would share it with you nonetheless:

“I have read a patient’s experiences of catheter insertions. He said his first one was excruciating and subsequent insertions became less and less bothersome. Nurses state that some men [say] the Foley catheter does not bother them at all. From common sense I see that there is callousing happening from urethra trauma (especially the first insertion. [This is a] compelling reason why patients should always have a condom catheter, and the Foley catheter used only when necessary. I am most concerned with the permanent nerve damage the very nerves that are also needed for optimum orgasmic intensity”.

The Right Diagnosis website claims that treatment for catheterophilia is generally not sought unless the condition becomes problematic for the person in some way and they feel compelled to address their condition. The site also claims that the majority of catheterophiles learn to accept their fetish and manage to achieve gratification in an appropriate manner.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Alison, L., Santtila, P., Sandnabba, N. K., & Nordling, N. (2001). Sadomasochistically oriented behavior: Diversity in practice and meaning. Archives of Sexual Behavior, 30, 1–12.

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Maddy’s Mansion (2010). Catheterophilia. October 4. Located at: http://maddysmansion.blogspot.co.uk/2010/10/catheterophilia.html?zx=b5754ebdc388557b

Money, J. (1986). Lovemaps: Clinical Concepts of Sexual/Erotic Health and Pathology, Paraphilia, and Gender Transposition of Childhood, Adolescence, and Maturity. New York: Irvington Publishers.

Pranzarone, G.F. (2000). The Dictionary of Sexology. Located at: http://ebookee.org/Dictionary-of-Sexology-EN_997360.html

Right Diagnosis (2012). Catheterophilia. February 1. Located at: http://www.rightdiagnosis.com/c/catheterophilia/intro.htm

Sandnabba, N.K., Santtila, P., Alison, L., & Nordling, N. (2002). Demographics, sexual behaviour, family background and abuse experiences of practitioners of sadomasochistic sex: A review of recent research. Sexual and Relationship Therapy, 17, 39–55.

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

About drmarkgriffiths

Professor MARK GRIFFITHS, BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA, AcSS. Dr. Mark Griffiths is a Chartered Psychologist and Professor of Behavioural Addiction at the Nottingham Trent University, and Director of the International Gaming Research Unit. He is internationally known for his work into gambling and gaming addictions and has won many awards including the American 1994 John Rosecrance Research Prize for “outstanding scholarly contributions to the field of gambling research”, the 1998 European CELEJ Prize for best paper on gambling, the 2003 Canadian International Excellence Award for “outstanding contributions to the prevention of problem gambling and the practice of responsible gambling” and a North American 2006 Lifetime Achievement Award For Contributions To The Field Of Youth Gambling “in recognition of his dedication, leadership, and pioneering contributions to the field of youth gambling”. His most recent award is the 2013 Lifetime Research Award from the US National Council on Problem Gambling. He has published over 600 research papers, four books, over 130 book chapters, and over 1000 other articles. He has served on numerous national and international committees (e.g. BPS Council, BPS Social Psychology Section, Society for the Study of Gambling, Gamblers Anonymous General Services Board, National Council on Gambling etc.) and is a former National Chair of Gamcare. He also does a lot of freelance journalism and has appeared on over 2000 radio and television programmes since 1988. In 2004 he was awarded the Joseph Lister Prize for Social Sciences by the British Association for the Advancement of Science for being one of the UK’s “outstanding scientific communicators”. His awards also include the 2006 Excellence in the Teaching of Psychology Award by the British Psychological Society and the British Psychological Society Fellowship Award for “exceptional contributions to psychology”.

Posted on August 12, 2014, in Case Studies, Compulsion, Gender differences, Obsession, Paraphilia, Psychology, Sex, Sex addiction and tagged , , , , , , , , , , , , , , , , . Bookmark the permalink. Leave a comment.

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