Sexual intercourse as a new option in the medical expulsive therapy of distal ureteral stones in males: A prospective, randomized, controlled study

To investigate the effect of sexual intercourse on the spontaneous passage of distal ureteral stones 5-10 mm in size. A total of 190 male patients with distal ureteral stones were randomly divided into three groups. Patients in group 1 were administered tamsulosin 0.4 mg/day (n = 60). Patients in group 2 were asked to have sexual intercourse at least three times a week (n = 66). Patients in group 3 received standard medical therapy alone and acted as the controls (n = 64). The expulsion rate was controlled after 2 and 4 weeks. Differences between the groups were analyzed statistically by the Chi-square and Student's t test. p < 0.05 was considered as statistically significant. The mean ages of the patients in groups 1, 2, and 3 were 34.4 +/- 13.5 (18-60), 38.6 +/- 14.1 (18-63), and 36.92 +/- 12.4 (18-59) years, respectively (p > 0.05). The mean stone size was 7.09 +/- 1.4 mm in group 1, 7.01 +/- 1.4 mm in group 2, and 7.1 +/- 1.3 mm in group 3 (p > 0.05). Spontaneous passage rates in groups 1, 2, and 3 were 81.6, 81.8, and 51.5%, respectively, and it was significantly higher in group 1 (p = 0.0394) and group 2 (p = 0.0350). There was no significant difference between groups 1 and 2 (p = 0.9925). The analgesic needs in groups 1, 2, and 3 were found to be 1.3 +/- 0.4, 1.2 +/- 0.6, and 1.4 +/- 0.4 times, respectively, and were significantly lower in the sexual intercourse group than in the control group (p = 0.0276). Tamsulosin and sexual intercourse increase the spontaneous passage of distal ureteral stones 5-10 mm in size. At least three sexual intercourses per week seem to be at least as effective as tamsulosin. Sexual intercourse also reduces the need for analgesics in ureteric colic due to ureteral stones.