Nature and Origin of “Squirting” in Female Sexuality Samuel Salama, MD,* † Florence Boitrelle, MD, ‡§ Amélie Gauquelin, CM, ‡ Lydia Malagrida, MD, ¶ Nicolas Thiounn, PhD, MD, † ** and Pierre Desvaux, MD ††† *Department of Gynaecology and Obstetrics, Hopital Privé de Parly 2, Le Chesnay, France; † AIUS (Association Inter disciplinaire post Universitaire de Sexologie), Pérols, France; ‡ Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, Poissy, France; § Versailles University of Medicine and Science, Versailles, France; ¶ Department of Medical Biology, Poissy General Hospital, Poissy, France; **Department of Urology, Hopital Europeen Georges Pompidou, Paris, France; †† Department of Urology, Hopital Cochin, Paris, France DOI: 10.1111/jsm.12799 ABSTRACT Introduction. During sexual stimulation, some women report the discharge of a noticeable amount of fluid from the urethra, a phenomenon also called “squirting.” To date, both the nature and the origin of squirting remain controversial. In this investigation, we not only analyzed the biochemical nature of the emitted fluid, but also explored the presence of any pelvic liquid collection that could result from sexual arousal and explain a massive fluid emission. Methods. Seven women, without gynecologic abnormalities and who reported recurrent and massive fluid emission during sexual stimulation, underwent provoked sexual arousal. Pelvic ultrasound scans were performed after volun- tary urination (US1), and during sexual stimulation just before (US2) and after (US3) squirting. Urea, creatinine, uric acid, and prostatic-specific antigen (PSA) concentrations were assessed in urinary samples before sexual stimulation (BSU) and after squirting (ASU), and squirting sample itself (S). Results. In all participants, US1 confirmed thorough bladder emptiness. After a variable time of sexual excitation, US2 (just before squirting) showed noticeable bladder filling, and US3 (just after squirting) demonstrated that the bladder had been emptied again. Biochemical analysis of BSU, S, and ASU showed comparable urea, creatinine, and uric acid concentrations in all participants. Yet, whereas PSA was not detected in BSU in six out of seven participants, this antigen was present in S and ASU in five out of seven participants. Conclusions. The present data based on ultrasonographic bladder monitoring and biochemical analyses indicate that squirting is essentially the involuntary emission of urine during sexual activity, although a marginal contribution of prostatic secretions to the emitted fluid often exists. Salama S, Boitrelle F, Gauquelin A, Malagrida L, Thiounn N, and Desvaux P. Nature and origin of “squirting” in female sexuality. J Sex Med **;**:**–**. Key Words. Squirting; Gushing; Female Orgasm; Urinary Incontinence; Female Ejaculation Introduction D uring sexual arousal or orgasm, some women report the involuntary emission of variable amounts of fluid [1] varying from 0.3 mL to more than 150 mL [2]. Although the prevalence of this phenomenon is difficult to evaluate, authors esti- mate that 10–40% of women may experience regularly or sporadically an emission of fluid during orgasm [2–4]. The exact nature of this fluid emission has been controversial for decades [5]. Indeed, whereas this fluid represents, for some authors, a mere vaginal hyper-lubrification [6]; for others, it is produced by the Bartholin’s glands [7] or by the Skene’s glands [8,9], also referred to as female prostate [10,11]. For some other authors, this fluid is rather a urinary emission [12,13]. More recently, insights were obtained into this issue, in particular, with the demonstration that 1 © 2014 International Society for Sexual Medicine J Sex Med **;**:**–**