Li Wenfeng, Mao Yuansheng, Lu Chao, Gu Yufei, Gu Xin, Hua Bao, Pan Weixin
Department of Urology, the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200011, China.
Urol J. 2020 Mar 16;17(2):134-138. doi: 10.22037/uj.v0i0.5400.
To explore whether sexual intercourse is beneficial to the clinical outcome of SWL for ureteral calculi of 7-15 mm in the distal ureter.
Between March 2016 and January 2017, 225 patents with a stone (7-15 mm) in distal ureter were randomly divided into three groups after SWL: Group 1 was asked to have sexual intercourse at least three times a week, Group 2 was administered tamsulosin 0.4 mg/d and Group 3 was received standard therapy alone and served as the controls. Stone free rate, time to stone expulsion, pain score at admission, number of hospital visits for pain and steinstrasse were recorded in 2 weeks.
70 patients in Group 1, 71 patients in Group 2 and 68 patients in Group 3 were enrolled to the study. At the end of the first week and the second week, the stone free rates for Group 1 (68.6%, 80.0%) and Group 2 (69.0%, 81.7%) were approximately the same, but were significantly higher than Group 3 (50.0%, 63.2%) (P = .031, P = .022). The VAS scores of Groups 1 and 2 were slightly higher than those of Group 3 (P = .233). The number of patients in Group 3 who visited the emergency room for pain was significantly higher than in the other two groups (P = .015). At the end of the second week, the incidence of steinstrasse in Groups 1 and 2 was significantly lower (2.9%, 2.8% vs 11.8%) (P = .034).
At least three sexual intercourses per week after SWL can effectively improve the stone free rate, reduce the formation of steinstrasse and relieve renal colic. It provides a choice for urologists in the SWL treatment of lower ureteral calculi.
探讨性交是否有利于体外冲击波碎石术（SWL）治疗远端输尿管7 - 15毫米输尿管结石的临床疗效。
2016年3月至2017年1月，225例远端输尿管结石（7 - 15毫米）患者在SWL术后被随机分为三组：第1组被要求每周至少进行三次性交，第2组给予坦索罗辛0.4毫克/天，第3组仅接受标准治疗并作为对照组。记录2周内的结石清除率、结石排出时间、入院时疼痛评分、因疼痛就诊次数及石街形成情况。
第1组70例、第2组71例和第3组68例患者纳入研究。在第一周和第二周结束时，第1组（68.6%，80.0%）和第2组（69.0%，81.7%）的结石清除率大致相同，但显著高于第3组（50.0%，63.2%）（P = 0.031，P = 0.022）。第1组和第2组的视觉模拟评分（VAS）略高于第3组（P = 0.233）。第3组因疼痛到急诊室就诊的患者人数显著高于其他两组（P = 0.015）。在第二周结束时，第1组和第2组石街的发生率显著较低（2.9%，2.8%对11.8%）（P = 0.034）。
SWL术后每周至少三次性交可有效提高结石清除率，减少石街形成并缓解肾绞痛。为泌尿外科医生在SWL治疗下段输尿管结石时提供了一种选择。
