Abstract
Purpose
To evaluate the effect of masturbation on the spontaneous expulsion of distal ureteral stones 5–10 mm in size.
Material and methods
A total of 128 men with distal ureteral stones were randomly divided into 3 groups. All patients received standard medical therapy. Patients in group 1 (n = 43) were instructed to masturbate at least 3–4 times a week, patients in group 2 (n = 41) received tamsulosin 0.4 mg/day, and patients in group 3 (controls, n = 44) received standard medical therapy alone. Rates of expulsion, need for analgesic, and ureterorenoscopic lithotripsy were compared between the groups.
Results
The mean ages of the patients in groups 1, 2, and 3 were 37 ± 5.0, 37.6 ± 4.6, and 38.4 ± 6.8 years, respectively (p = 0.7). The mean stone size in each group was 6.93 ± 1.1 mm, 7.1 ± 0.9 mm, and 6.87 ± 1.1 mm, respectively (p = 0.4). Spontaneous passage rates in groups 1, 2, and 3 were 81.4%, 80.5%, and 43.2%, respectively, and were significantly higher in group 1 (p = 0.001) and group 2 (p = 0.001) when compared with group 3. Analgesic requirement in groups 1, 2, and 3 was 1.7 ± 0.6, 1.5 ± 0.6, and 1.8 ± 0.6 times per day, respectively, and was significantly lower in the tamsulosin group than in the control group (p = 0.004)
Conclusion
Masturbation and tamsulosin increased the spontaneous passage of distal ureteral stones 5–10 mm in size. Masturbating at least 3–4 times a week was as effective as tamsulosin. Masturbation and tamsulosin also reduced the need for ureterorenoscopic lithotripsy.
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References
Moe OW, Pearle MS, Sakhaee K (2011) Pharmacotherapy of urolithiasis: evidence from clinical trials. Kidney Int 79(4):385–392. https://doi.org/10.1038/ki.2010.389
Xu B, Yan H, Zhang X, Cui Y (2019) Meta-analysis of the efficacy of sexual intercourse for distal ureteric stones. J Int Med Res 47(2):497–504. https://doi.org/10.1177/0300060518814116
Türk C et al (2016) Platinum priority-guidelines EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69(3):475–482. https://doi.org/10.1016/j.eururo.2015.07.041
Preminger GM et al (2007) Guideline for the management of ureteral calculi. Eur Urol 52(6):1610–1631. https://doi.org/10.1016/j.eururo.2007.09.039
Türk C et al (2016) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 69(3):468–474. https://doi.org/10.1016/j.eururo.2015.07.040
Choi T et al (2015) Analysis of factors affecting spontaneous expulsion of ureteral stones that may predict unfavorable outcomes during watchful waiting periods: what is the influence of diabetes mellitus on the ureter? Korean J Urol 56(6):455–460. https://doi.org/10.4111/kju.2015.56.6.455
Loftus C et al (2016) Medical expulsive therapy is underused for the management of renal colic in the emergency setting. J Urol 195(4):987–991. https://doi.org/10.1016/j.juro.2015.11.026
Sarier M et al (2018) Outcomes of conservative management of asymptomatic live donor kidney stones. Urology 118:43–46. https://doi.org/10.1016/j.urology.2018.04.035
Preminger GM et al (2007) Guideline for the management of ureteral calculi. J Urol 52(6):1610–1613. https://doi.org/10.1016/j.juro.2007.09.107
Ordon M, Andonian S, Blew B, Schuler T, Chew B, Pace KT (2015) CUA guideline original research CUA guideline: management of ureteral calculi. Can Urol Assoc J 9(11–12):837–851
Zhou SG, Lu JL, Hui JH (2011) Comparing efficacy of α 1D-receptor antagonist naftopidil and α1A/D-receptor antagonist tamsulosin in management of distal ureteral stones. World J Urol 26(6):767–771. https://doi.org/10.1007/s00345-011-0739-3
Al-Ansari A, Al-Naimi A, Alobaidy A, Assadiq K, Azmi MD, Shokeir AA (2010) Efficacy of tamsulosin in the management of lower ureteral stones: a randomized double-blind placebo-controlled study of 100 patients. Urology 75(1):4–7. https://doi.org/10.1016/j.urology.2009.09.073
Doluoglu OG et al (2015) Can sexual ıntercourse be an alternative therapy for distal ureteral stones? a prospective, randomized, controlled study. Urology 86(1):19–24. https://doi.org/10.1016/j.urology.2015.03.037
Abdel-Kader MS (2017) Evaluation of the efficacy of sexual intercourse in expulsion of distal ureteric stones. Int Urol Nephrol 49(1):27–30. https://doi.org/10.1007/s11255-016-1448-z
Mastrangelo D, Baertschi AJ, Roatti A, Amherdt M, Iselin CE (2003) Nitric oxide production within rat urothelial cells. J Urol 170(4):1409–1414. https://doi.org/10.1097/01.ju.0000083492.80217.20
Andersson KE (2011) Mechanisms of penile erection and basis for pharmacological treatment of erectile dysfunction. Pharmacol Rev 63(4):811–859. https://doi.org/10.1124/pr.111.004515
Fernandes VS, Hernández M (2016) The role of nitric oxide and hydrogen sulfide in urinary tract function. Basic Clin Pharmacol Toxicol 119:34–41. https://doi.org/10.1111/bcpt.12565
Courtois F, Carrier S, Charvier K, Guertin P, Journel N (2013) The control of male sexual responses. Curr Pharm Des 19(24):4341–4356. https://doi.org/10.2174/13816128113199990333
Krassioukov A, Elliott S (2017) Neural control and physiology of sexual function: effect of spinal cord injury. Top Spinal Cord Inj Rehabil 23(1):1–10. https://doi.org/10.1310/sci2301-1
Bayraktar Z, Albayrak S (2017) Sexual intercourse as a new option in the medical expulsive therapy of distal ureteral stones in males: a prospective, randomized, controlled study. Int Urol Nephrol 49(11):1941–1946. https://doi.org/10.1007/s11255-017-1677-9
Hermanns T, Sauermann P, Rufibach K, Frauenfelder T, Sulser T, Strebel RT (2009) Is there a role for tamsulosin in the treatment of distal ureteral stones of 7 mm or less? results of a randomised, double-blind, placebo-controlled trial. Eur Urol 56(3):407–412. https://doi.org/10.1016/j.eururo.2009.03.076
Yilmaz E, Batislam E, Basar MM, Tuglu D, Ferhat M, Basar H (2005) The comparison and efficacy of 3 different α1-adrenergic blockers for distal ureteral stones. J Urol 173(6):2010–2012. https://doi.org/10.1097/01.ju.0000158453.60029.0a
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HT: writing-concept, HT: data collection, MS: literature search, MS: critical review, HT: analysis, HT: other.
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The study was approved by the local ethics committee (approval no: 2018/01/109) and written informed consent was received from all participants. The study protocol conformed to the ethical guidelines of the 1975 Helsinki Declaration.
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Turgut, H., Sarıer, M. Evaluation of the efficacy of masturbation on distal ureteral stones: a prospective, randomized, controlled study. Int Urol Nephrol 53, 655–660 (2021). https://doi.org/10.1007/s11255-020-02672-y
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DOI: https://doi.org/10.1007/s11255-020-02672-y