Evaluation of the efficacy of masturbation on distal ureteral stones: a prospective, randomized, controlled study
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UROLOGY - ORIGINAL PAPER
Evaluation of the efficacy of masturbation on distal ureteral stones: a prospective, randomized, controlled study Hasan Turgut1,2 · Mehmet Sarıer3 Received: 6 July 2020 / Accepted: 28 September 2020 © Springer Nature B.V. 2020
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. Keywords Masturbation · Tamsulosin · Ureteral stone
Introduction Urolithiasis is a global health problem with a predicted annual incidence of 1% [1]. Ureteric stones comprise 20% of all urinary stones, with 70% of these located in the distal ureteric segment [2]. Therapeutic options for urolithiasis include invasive and noninvasive methods such as medical expulsive therapy (MET), conservative therapy, observation for spontaneous passage, extracorporeal shockwave
* Hasan Turgut [email protected] 1
Faculty of Health Science, Avrasya University, Trabzon, Turkey
2
Department of Urology, Medicalpark Karadeniz Hospital, Ortahisar, 61000 Trabzon, Turkey
3
Department of Urology, Istinye University Medical Faculty, Istanbul, Turkey
lithotripsy (ESWL), and ureterorenoscopic lithotripsy (URSL) [3]. In 2007, the use of alpha blockers as MET for uncomplicated distal ureteral stones smaller than 10 mm was introduced through collaboration between the European Association of Urology (EAU) and American Urological Association (AUA) [4, 5]. Alpha adrenergic blockade was shown to decrease the basal tone of the distal ureter by reducing contractions and peristaltic frequency [6]. However, the authors recommended that MET not exceed 4 weeks. Patient
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