PIERRE — A mesh bag blurred Dirk Sparks' vision.

He lay hooded and handcuffed as four police officers pinned him to a hospital exam table.

Through the patterned light, he saw a fifth officer filming the procedure.

His pants were loosened and pulled below his waist.

Then, pain.

A nurse at Avera St. Mary's Hospital in Pierre inserted a pencil-sized tube into Sparks' urethra to drain his bladder. Moments later, an officer with the Pierre Police Department held a cup of Sparks' urine that soon would be sent off for drug testing.

“It was degrading,” Sparks said. “I was angry. I felt like my civil rights were being violated.”

Hours earlier, police responded to a domestic dispute at Sparks' home. When officers observed him acting "fidgety," they asked for a urine sample. When Sparks refused, police sought a warrant from a Hughes County judge to obtain a urine sample by "medically accepted means."

In Pierre, those means have repeatedly included forcibly catheterizing people who refuse or are unable to provide a sample. Officers subjected a 3-year-old boy to a similar procedure in February as part of a child welfare investigation, according to the American Civil Liberties Union.

“Quite frankly, it’s cruel and barbaric to forcibly catheterize anyone, let alone a 3-year-old child, and this process raises serious constitutional concerns,” said Heather Smith, executive director of the ACLU of South Dakota.

The Pierre Police Department and Avera Health declined repeated requests for interviews. The police department deferred questions to the Hughes County State's Attorney's office, which also did not respond to multiple phone calls.

The use of catheters to forcibly extract urine samples from criminal suspects has drawn lawsuits in others states, though courts have generally sided with the police. South Dakota Attorney General Marty Jackley said the practice is appropriate in some situations.

Not all police departments in South Dakota use the method. In Sioux Falls, law enforcement leaders view the practice as overly invasive and an inefficient use of officers' time for lower-level crimes in which suspects are unlikely to face more than probation if convicted.