Urethral intercourse or coitus per urethram is sexual penetration of the female urethra by an object such as a penis or a finger. It is not the same thing as urethral sounding , the act of inserting a specialized medical tool into the urethra as a form of sexual or fetishistic activity. The untrained insertion of foreign bodies into the urethra carries a significant risk that subsequent medical attention may be required. Documented cases of urethral intercourse appear to have occurred between heterosexual couples; a survey of the global medical literature available in reported accounts of thirteen separate cases. Presenting symptoms of unintentional urethral intercourse include primary infertility , dyspareunia pain during intercourse , and incontinence.