Sexual Intercourse May Clear Distal Ureteral Stones

Having sex 3-4 times a week was associated with a significantly greater stone passage rate than tamsulosin or standard medical therapy.

Source: Sexual Intercourse May Clear Distal Ureteral Stones

This was an interesting study that compared men that had stones that they were trying to pass.  Some of the men were treated with flomax, which is commonly prescribed to help pass stones by allowing the ureter (kidney drainage tube) to relax and allow the stone more room to pass.  Other men were not given anything and some of the men had regular sexual intercourse.

The men that had regular sexual relations had the highest rate of passing stones.

I will start advising my patients to increase sexual activity when trying to pass stones based on this study.

Robotic Pyeloplasty and Endoscopic Stone retrieval

I was recently faced with a case of a right sided UPJ stenosis with good renal preservation and two 5 mm stones in the upper pole. Having done at least a half dozen robotic pyeloplasties I felt that that would be the appropriate treatment for the UPJ but was not sure how to address the stones. I did not want to leave them in place and have to address them later. A separate percutaneous nephrostolithotomy seemed like overkill for the size of the stones. A PNL could be combined with an antegrade endopyelotomy, but the stones were in upper pole calyces and the combined procedure might require two separate entry points for adequate access (lower pole entry point to reach the upper-pole and a mid- or upper-pole entry point to reach the UPJ).

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