A very common question that may arise when you failed all the other solutions is: does ejaculating get rid of kidney stones? The answer is yes, in some cases. Studies indicate that sexual activity, and by association ejaculation or masturbation, has a modest effect of increasing the likelihood that small distal ureteral calculi (up to 610 mm) will pass. It does not cure everything, it is not in all guidelines challenged, and it is most effective as an adjuvant to conventional care.
Why sexual activity may assist?
Nitric oxide (NO) released during the sexual arousal process and orgasm relaxes the smooth muscle in the body. The lower ureter is composed of smooth muscle and increased activity can transiently eliminate uretal cramps and oedema, slightly dilation of the lumen and facilitate the passage of stone. This is analogous to how some prescription drug action works (see below). There is limited evidence, however, biologically plausible.
What Do The Studies Demonstrate?
- A study in men with distal ureteral stones randomized to sexual intercourse 3-4 times per week or control/placebo found that sexual intercourse was associated with increased spontaneous passage of the stone compared with control. The gain was predominant at stones size of or smaller than 6 mm.
- Meta-analyses show that sexual intercourse is effective as compared to placebo in distal ureteral stone and may also help in reducing the episodes of pain and analgesics. On that note, sample sizes are small and the majority of research participants are males.
- Masturbation/sexual stimulation seems to have an equivalent effect in analyses currently underway concentrated on distal or intramural stones, but once again, data are premature.
Important exclusions: General exclusions to these studies include individuals with fever, unstable pain, solitary kidney, pregnancy, and large/proximal stones. The results are inapplicable in case of sexual activity with kidney stones that are currently still in the first stages of the kidney or with large stones.
What Is The Comparison With Usual medical expulsive therapy (MET)?
Doctors usually give medicines to relax ureter so that the stones can pass out :-
Alpha-blockers (e.g. tamsulosin): Being strongly recommended by European guidelines in distal ureteral calculi >5mm, commonly used in practice.
They enhance NO/cGMP signaling as well (e.g., tadalafil, sildenafil). Pooled recent results indicate that tadalafil is comparable or better (redochen orbs) than tamsulosin against distal ureteral stones of less than or equal to 10 mm, with comparable safety. In certain studies, expulsion is quicker and there is less colic. Not standard in all guidelines but evidence is mounting.
Guideline note: 2016 contemporary urology guidelines continue to promote treatment of kidney stones with alpha-blockers as initial therapy; 2012-2013 guidelines also promoted PDE-5 inhibitors as an emerging therapy available as a choice or adjunct therapy to 2x MET. The surgical guidelines concentrate on indications of when to intervene (ESWL, ureteroscopy) in event of observed/MET failure.
Where ejaculation applies: Sex as a low-risk supplement to eligible patients attempting to expel a small distal ureteral stone should not be seen as a substitute to evaluation, pain management, hydration, and prescribed MET when appropriate.
Who will benefit (and who needs to avoid it?)
May consider attempt (after a clinician verifies that it is safe):-
- Adults clinically stable with diagnosed distal ureterine stones that do not exceed 610mm in size, without fever, and controlled pain without signs of infection.
- Individuals who are already on MET (e.g., tamsulosin ± tadalafil) and wish to have an additional, non-drug intervention.
Do not engage in sexual activity and go to seek urgent care when you have:-
- High fever or shivers (potentially infected and blocked system- an emergency)
- Uncontrollable/increasing pain, recurrent vomiting, or the inability to avoid the spilling of fluids
- One kidney, kiddie with a known kidney failure, or pregnant
- No urination or muscle weakness/ dizziness
These are situations that require assessments that are urgently needed and in most cases interventions are implemented.
Actionable game plan (evidence-based and patient-friendly)
Determine stone size and the position. Ultrasound/CT determines whether you have a distal ureteral stone that would be likely to pass spontaneously.
Hydrate sensibly. Take sips of water frequently to keep the color of urine light-yellow and avoid forced fluids when they aggravate pain or nausea.
Pain control. Nonsteroidal anti-inflammatory drugs (assuming they are safe to your health) alleviate ureteral inflammation and spasm; your physician will determine the administration dose.
Enquire on MET. Tamsulosin is usual (in special cases, tadalafil/sildenafil can be used). Blood pressure and other medications along with their side effects will be considered by your doctor.
Add sexual activity on an as-needed basis. In eligible patients sexual intercourse or masturbation 3 4 times per week during the observation period can be attempted; discontinue in case it aggravates pain.
Strain your urine. Take the stone to be analyzed–prevention henceforth depends on composition.
Know the stops. In the event that the stone has not entered the ureter after ~46 weeks, or much sooner in the case of increased symptoms, consult ureteroscopy or shockwave lithotripsy
Bottom line
- Ejaculation/ sexual activity can aid in the passage of small distal ureter stones in some patients, probably related to its relaxing effect on the ureter through nitric-oxide mediated mechanisms.
- It is not a cure but is an adjunctive product and not suited in patients that have infection and in patients with severe illness or in high-risk conditions.
- α-Blockers constitute the strongest, guideline supported MET with PDE-5 inhibitors exhibiting positive evidence in recent studies. Discuss the plan with a urologist in keeping with your urolith size, location, and health condition.
Come and Receive Expert Care in Gurgaon
When it comes to dealing with a suspected stone or persistent colic, seeking a consultation with Dr. Deepanshu Gupta who is a highly recognized kidney stone specialist works well in the Gurgaon area. With proper diagnosis and pain management, a good choice between MET, shockwave therapy, or even endoscopic removal, Dr. Gupta provides effective guidance and timely treatment that will see you back to normal in the shortest time possible with minimal risk. Book a call to know more!