New Delhi, Oct 21 (IANS): A recent Turkish study claiming that having sex at least three to four times a week can help ease the spontaneous passage of small kidney stones has taken the Indian urologists by surprise.

While they agree that probably the release of a key compound that is an integral part of sex and heart health can help pass small stones, they cannot yet tell their patients to go have sex to get rid of kidney stones.

"Probably the relaxing effect of nitric oxide (a gas that is naturally produced in the body) is released during erection on the smooth muscles of ureter. This, however, requires a lot of further clinical trials to establish its use," Dr Sanjay S Nabar, consultant urologist and andrologist at Nanavati Super Specialty Hospital in Mumbai told IANS.

"We cannot yet advise sex as a definitive treatment which also has a lot of social barriers to be adopted as definitive treatment,” he said.

The results of the Turkish study, published in the journal Urology, where among patients having distal ureteric stones, less than 5 mm in size, showed that about 83 percent patients spontaneously passed the stones after having sexual intercourse thrice or four times in a week.

"The investigators postulate that nitric oxide released during erection and sexual intercourse may affect the distal ureters, causing relaxation of urethral muscle. At this stage, before more scientific data is available, we can not prescribe this to our patients," added Dr Anurag Khaitan, senior consultant (urology) at Paras Hospital in Gurgaon.

The researcher from the Clinic of Ankara Training and Research Hospital in Ankara, Turkey split 75 participants into three groups.

The first group was asked to have sex at least three to four times per week.

Two weeks later, the researchers found that 26 of the 31 participants from the sex group were able to pass their kidney stones (6 mm or less in size).

"Our results have indicated that patients who have small kidney stones and a sexual partner may be advised to have sexual intercourse three-four times a week to increase the probability of spontaneous passage of the stones,” the authors commented.

"However, the observation was seen in a very small study and needs further large studies to confirm the findings," Dr Khaitan said.

According to Dr. Ashok Bhatia, senior laparoscopic surgeon at RG Stone urology and laparoscopy kospital in New Delhi, advising people in pain to go and have sex to clear kidney stones will not be a good idea unless it is proven in large, clinical studies.

"Medication and drinking plenty of water is the best way to remove small stones," he said.

Another thing that most of people suffering from kidney stones do is to gulp down beer after beer.

"Beer basically works as a diuretic. But it contains lot of purines and oxalates -- both responsible for stone formation and stone growth. There is a risk of increasing the size of a stone lying in the corner of kidney or one impacted in the ureter,” Dr Nabar stresses.

Nearly 90 percent of kidney stones constitute calcium oxalate and rest uric acid.

"Though low-oxalate bottled beer is available, it will be better to stick to plain water which will have a good diuretic effect,” Dr Nabar advises.

According to Dr Khaitan, long-term beer use increase the incidence of stone formation due to high oxalate contents, increase blood uric acid levels and late onset dehydration.

"So medically, we do not advise beer intake for stone expulsion. The patient is advised to take plenty of liquids, antispasmodics and alpha-blocker drugs and at times, calcium channel blockers,” he explains.

"Based on our 25 years of treating kidney stones, it is our opinion that the increased urine output helps flush out the stones and not the beer. The same effect can be achieved by increasing fluid intake in any form," informs Dr S.S. Sibia from world-famous Sibia Medical Centre in Ludhiana.

Use of diuretic medicines under medical supervision, simple exercises like jogging and rope skipping can also help in expulsion of ureteric stones along with diuretic therapy, the experts say.