Nephrolithiasis, commonly known as kidney stones, are hard deposits of crystallized minerals and salts that form inside the kidneys. The most frequent type is calcium oxalate. These stones cause intense pain, referred to as renal colic, when they move from the kidney and become lodged in the narrow tubes called ureters. Many people explore non-invasive methods to hasten the passage of these painful obstructions.
Scientific Evidence for Stone Passage
Research has investigated whether regular sexual activity increases the likelihood of a stone passing naturally. A specific study at the Ankara Training and Research Hospital in Turkey examined 75 male participants with stones located in the lower ureter. Participants were divided into three groups: one instructed to have sexual intercourse three to four times a week, a second receiving the alpha-blocker tamsulosin, and a control group receiving standard medical advice. The results after two weeks showed a significantly higher stone expulsion rate in the active group (83.9%) compared to the tamsulosin group (47.6%) and the control group (34.8%). Since the stones studied averaged 4.7 millimeters, researchers concluded the approach might be useful for stones up to 6 millimeters, positioning it as a low-risk, adjunctive therapy.
The Proposed Physiological Mechanism
The theory centers on the body’s natural physiological response during arousal and climax. During this process, the body releases nitric oxide (NO), which acts as a powerful smooth muscle relaxant. The ureter, the tube the stone must travel through, is lined with smooth muscle, and its involuntary contractions cause spasm and pain. Nitric oxide promotes relaxation by increasing levels of cyclic guanosine monophosphate (cGMP) within the muscle cells. This causes the ureter’s smooth muscle to relax and widen, potentially reducing spasm and facilitating stone passage. The effect is similar to how a pharmaceutical alpha-blocker works, but achieved through a natural biological process.
Limitations and Necessary Precautions
This approach is only recommended for small stones located in the lower ureter, which are most likely to pass spontaneously. Stones 5 millimeters or less have a high chance of passing on their own, but the odds drop significantly for stones larger than 6 millimeters. Attempting this method with a stone greater than 6 millimeters is unlikely to be successful and may delay necessary medical intervention.
Patients should never attempt this method if they have signs of a severe urinary tract infection, uncontrolled pain, or a high-grade obstruction blocking urine flow. These symptoms require immediate medical attention, as a blocked and infected kidney is a serious health threat. While waiting for a small stone to pass, maintaining high fluid intake and using prescribed pain management remains important.
Established Medical Interventions
When a stone is unlikely to pass on its own, urologists rely on standard clinical interventions. One non-surgical option is Medical Expulsive Therapy (MET), which involves prescribing alpha-blockers like tamsulosin. These medications relax the smooth muscle in the ureter, aiming to widen the passage and reduce painful spasms, thereby increasing stone passage rates.
For larger stones, or those that fail to pass with MET, procedural interventions are required.
Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL is a common non-invasive treatment that uses focused sound waves to break the stone into tiny fragments that can be passed in the urine.
Ureteroscopy
A urologist may perform a ureteroscopy, which involves passing a thin, flexible scope through the urethra and bladder up to the stone. The stone is then either removed directly using a small basket or broken up with a laser, offering high stone-free rates even for larger obstructions.