Tom A Gordon
Table of Contents
(cath) can refer medically to any tube which is inserted into the
body to give access to an internal organ from outside. But in SM
the term is most likely to refer to a tube inserted into the urethra
to access the bladder. This sort of catheter is usually made of rubber,
occasionally of plastic, and frequently has some form of device to hold
it in place.
Regretfully, so far this briefing only covers male catheterization.
Women's catheters are shorter, for the shorter urethra, and have their
own difficulties of insertion, since the urethral opening is harder to
find -- indeed there may be multiple ones. Women are also even more
prone to infection. Some of this briefing may be of relevance and
interest to women, but the technical aspects are largely inapplicable.
A word of caution: This kind of play is not something you should
engage in with someone who is inexperienced or who does not understand
all the necessary precautions. Carelessness can result in infection,
injury, or other traumatic problems. You should be introduced to this
kind of play in the right setting by an experienced, careful person
who cares enough about you to exercise all the cautions set forth
herein. Even an experienced person should get an extra catheter
and practice all of the steps below
trying to insert a cath -- especially the steps involving inflation
and deflation of the balloon.
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What's the Thrill?
aspect of catheter play is the physical sensation and psychological
effect of having an object inserted into the urethra, which is strangely
sensitive. Catheter games can also involve medical imagery, piss play
and the peculiar penetrative vulnerability of having an object inserted
deep inside the body, into what is in actual fact an internal organ.
The biggest thrill for most people, though, is most likely control.
Catheterized people have no control over their urinary function: if
the catheter is left open, the bladder will drain completely and
continue to drain as more urine is produced. If the tube is clamped
piss, even if they wish and need to.
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What to Use
are several kinds of catheters, usually named after their inventor
or on the basis of the kind of tip they employ. The best catheters
are made of latex rubber coated with Teflon, which makes them very
smooth when lubricated. Some catheters are made of plastic which
becomes very flexible at body temperature; these are usually little
more than simple tubes with a slight 'funnel' at one end. By far the
most common type for use in sex play, and the type to be preferred,
catheter. This has a balloon device that allows it to be left
securely in place for a significant length of time; others will
Construction of the Foley Catheter
Foley catheter has a rounded tip, one or two 'eyes' (holes through
which the urine enters the main tube), and a tiny balloon that can
be inflated once the catheter is in place. Before insertion the
balloon is evident as just a slightly raised area near the tip of
The 'outside' end has two branches. One is the main tube, connected
directly to the eyes, through which urine flows. The other, which has
a small valve on the end, runs inside the main tube and is connected
to the inflatable balloon at the tip.
The valve is important: there are three types. One is operated by a
a needle. The other type is essentially a plug of soft rubber
and requires a hypodermic syringe
a large-gauge needle (a gauge 18 would be fine). A third type
has a bulb already filled with sterile water for inflating the
balloon, and a clamp to enable the water to flow.
factory-sterilized catheters should be used. They are packed in
sterile, sealed paper/plastic peel-open sleeves. Avoid the temptation
to try to sterilize a used catheter. Sterility is essential! New
factory-sterilized catheters cost about GBP2.50 (US$4) through
medical supply sources, and although non-sterile catheters are
also sold, you probably do not have the equipment to sterilize
them properly and maintain sterility until use. Some states require
a prescription for catheter purchase.
catheters are the same length -- about 430mm (16"). But there are
two size variables: the diameter of the catheter and the size of
the balloon. In buying a Foley catheter, you must describe it by
both of these dimensions.
Like some other medical items, catheters are sized in the French
system. One French unit (Fr) is 0.33mm (0.012"). Thus, an instrument
which is 20Fr is 20 x 0.3 = 6mm (0.24") in diameter.
How big a catheter do you want? Most adult males can
handle a 14Fr, and 16Fr or 18Fr is very common. If the opening
of your penis is fairly small, opt for a 14Fr; if it's average,
try a 16Fr; if it's a bit larger, try an 18Fr. The urethra can
also be enlarged over time by the use of
The balloon of a Foley cath is sized in ml (cc). Typical sizes
are 5, 10, and 30ml. I recommend 30ml for reasons which will be
made clear below.
So if you are an average sort of guy, you might want a 16Fr/30ml
Foley catheter, sterile.
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Other Equipment for Catheterization
well as the catheter, you will need:
A sterile hypodermic syringe (luer tip is good), of
about 10-12ml capacity.
A sterile hypodermic needle, around 18 gauge, 25 or
40mm (1" or 1.5") long, if required for valve.
If you intend to take total control of the bladder, a
sterile catheter syringe. This is essentially a very
large hypodermic syringe (60ml or more) with a large
plastic tip which fits into the outflow tube of the
catheter. This must be sterile, sealed in a
factory-sterilized package. Otherwise you will need a
spigot or clamp to prevent the bladder emptying
Sterile lubricant. Some brands are stabilized with a
preservative which can burn slightly when it is in
contact with sensitive tissues. KY and H&R brands seem
to be the best since they are minimally irritating.
use lubricant which contains nonoxynol-9: it is quite
irritating to the urethral tissues.
A sterile --or at least clean -- towel
Washcloth, soap, and water.
All the specialist items should be available via medical
suppliers. See the
section of the Play Piercing fact sheet.
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Inserting the Catheter
beginning, fill the hypodermic syringe with sterile water. Wash
your hands carefully with soap and water.
Place the bottom on his back in a comfortable position, legs
slightly spread. Wash his penis with soap and warm water, carefully,
and rinse with plain water, to reduce the surface bacterial count.
Anti-bacterial soap may be efficacious. Ideally this would be a
sterile procedure, but even in hospitals it cannot be done with
full sterility. Some people advocate washing the penis with Betadine,
but I do not believe this helps a lot, and it is both a mess and
highly staining. A wipe with a Betadine swab is slightly less so.
Put on the latex gloves. Be careful what you touch after this
point. Unfold the sterile towel and put it on his belly. Put
the unopened catheter on the towel.
the valve-end of the catheter package. Attach the sterile
catheter syringe to the large opening. Determine whether the
valve requires the needle or not. If so, fit the needle to the
12ml syringe now but do not attach it to the catheter.
Put a small blob of lubricant right on the tip of the penis,
at the urethral opening. Carefully remove the catheter from
its package, setting the syringe end on the towel. Generously
the first 75mm (3") of the catheter and insert it gently
into the penis. Continue to insert slowly, twisting the cath
slightly to be sure its passage is fully lubricated. As you
insert more of the cath, lubricate it in 75mm sections. (It
is too slippery to handle if you lubricate it all at once.)
Depending on the length of the person's penis, you will
probably be able to insert about 25cm (10") of the cath.
At some point you will feel slight resistance, and the
bottom will report feeling a 'pinch; in a place he cannot
describe. You have reached the bladder sphincter muscle,
which keeps the bladder closed. Ask the bottom to relax
and try to piss a bit -- the catheter should slip into
the bladder. When you have inserted about 35-38cm
(13"-14") of the catheter, stop. If the bottom has a
short penis, stop sooner.
We must now check to be
the catheter is properly placed in the bladder. We do
trying to withdraw some urine into the catheter syringe.
If you do have urine flow, you are in the bladder. If not,
you need to insert the catheter farther. Do not go on to
the next step until there is evidence of urine in the
catheter syringe. The bottom should feel no real pain.
If you do not use a catheter syringe, the point where
the bladder is reached is obvious, since there is a gush
of urine from the catheter. You should clamp the end of the
cath or block it with a spigot, then push a further 75cm (3")
or so into the bladder to be on the safe side.
When the cath is in the bladder, attach the hypodermic syringe
to the valve and
inflate the balloon with water by pressing the plunger of the
syringe. It should not be more than the rated capacity of the
balloon. I usually use a 30ml balloon and inflate it to 12-15ml,
or about half its stated capacity. If the balloon breaks, you
could have a problem. If the bottom feels any pain at this point,
You probably do not have the balloon in the bladder. After the
balloon is inflated, note how much water you have put in, then
remove the hypodermic syringe from the valve; the balloon will
stay inflated. Keep the catheter syringe in place.
Alternatively if you are using a ready-filled catheter release
the clamp that holds the water out of the balloon.
If all has gone well, the balloon is in the bladder. Slowly
pull out on the catheter; you will feel resistance, at which
point you should stop. The balloon is now at the 'neck' of the
bladder, and everything is under control.
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While the Catheter is in
can now withdraw some urine with the catheter syringe, or you
can return the urine to his bladder by the same mechanism. If
you remove the catheter syringe from the cath, your bottom will
piss until he is empty. Even after he is empty, he will have the
sensation that he
disconnect the catheter syringe and then try to reconnect it
and refill him. You will get air in the bladder, and you don't
want to do that. You may clamp off the catheter to prevent
leakage or to prevent him from pissing when he thinks he needs
to. (He will probably have some confused feelings.) I did one
scene in which the bottom was blindfolded, and reacted very
eagerly when some of his own piss was dripped on his lips
from the syringe.
Some people also like to play elaborate piss recycling games
by connecting a catheter to a leg-bag (as supplied for incontinent
patients), and the outlet of the bag into a drinking tube or gag.
Be gentle with the penis once the cath is in place, and avoid
disturbing it too much. Resist any urge to masturbate: this
will irritate the urethra and if done vigorously it could
injure the bladder or sphincter muscles or nerves.
A Foley cath may be kept in place for awhile, but certainly
not with the tube clamped off; you don't want to keep it shut
off for so long that urine backs up toward the kidneys. If he
needs to piss, unclamp the tube and let him. Although caths are
often kept in place for days in a hospital, I recommend that
you do not leave it in place for longer than one to two hours
while you play.
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Removing the Catheter
deflate the balloon. Re-attach the hypodermic syringe as you did
before, and the pressure from the balloon may cause the syringe
to refill. Exert a bit of suction with the syringe:
you have taken out as much water as you put in; the balloon
must be deflated.
Now slowly withdraw the catheter. The bottom may feel slight
discomfort, as the balloon has been slightly deformed and it
may not be as perfectly smooth as it was before insertion. Wash
off any excess lubricant which may emerge from the tip of the
The first two or three times the bottom urinates, he may feel
a slight burning sensation. This is normal and is caused by
irritation of the urethra; it should go away within 12-24 hours.
Urge the bottom to drink a lot of fluids so that he pisses a lot:
this will give him the chance to flush out any germs before they
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Health and Safety Problems
is very important to put the catheter in carefully since there
is always a chance it can go astray in the urethra and cause real
damage. Go slowly and with great care. Though the bottom will feel
strange and uncomfortable, particularly if this is a new experience,
there should be no real pain. If there is, something is going wrong.
It is also a good idea to make sure the bottom hasn't pissed for half
an hour or so before the insertion, so there will be some urine in
the bladder to help confirm the cath is in place. When in doubt,
withdraw the catheter (as carefully as you put it in) and try
again another day with a fresh cath. Do not attempt to re-use a
cath once withdrawn.
Valve or Balloon Failure
is a small possibility that the valve will malfunction and you
won't be able to deflate the balloon. If this happens, don't
panic. Simply cut off the valve with scissors; the water will
gush out. Now try to attach the syringe to suck out more. The
rubber-plug valves (used with a needle) are less prone to failure
than the force-fit valves which do not use a needle.
There is a smaller possibility that the balloon will break inside
the bottom. By under inflating it, you reduce this risk even further.
And by using sterile water you ensure that anything that might be
introduced into the bladder this way is harmless. Withdraw the
and inspect the balloon to be sure there are no missing pieces left
inside (highly unlikely). Then let the bottom piss to rid himself
of the water from the balloon.
infection in the urethra or bladder is the most common danger
of catheterization. The risk of this can never be eliminated
totally -- even in hospitals, where caths are inserted in the
best of conditions, infections still occasionally occur. The
risk can be minimized, however, by following the procedures
carefully, using only sterile catheters, and encouraging copious
pissing after removal.
If infection does occur, it can be unpleasant, but is rarely
a problem if medical help is sought and normally responds well
to antibiotics. The symptoms, normally developing within a couple
of days of catheterization, include discomfort in the bladder, a
constant urge to piss, cloudy urine and maybe feverishness or a
feeling of being under the weather. Visit a doctor or a
genito-urinary/STD clinic, swallow your embarrassment and tell
them what the most likely cause is. Don't put off going: infections
can cause serious problems if allowed to take hold. Make sure
you're fully recovered before indulging in catheter play again,
and indeed any other sort of piss play, especially involving
Viral infection involving blood-borne viruses like HIV and
Hepatitis is highly unlikely in this sort of play. Urine is
normally sterile and will not contain these viruses. However,
any game involving exchange of urine via catheters is probably
ill-advised, since blood traces sometimes get into urine, and
the likelihood of this is increased because of possible minor
abrasions and injuries during the insertion.
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This article was first circulated on the Internet in 1996 under the
title 'About Catheters'. This version has been revised and expanded
slightly by Dirk. © Copyright Tom A. Gordon 1996, 1997. All