Can You Have Sex After Kidney Stone Treatment? Prevention Tips and Dietary Advice - Urology

Dr. Li Yilun reply Urology

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After undergoing extracorporeal shock wave lithotripsy (ESWL) for kidney stones, it is essential to increase fluid intake and rest.
If there are no discomforts, ESWL is unrelated to sexual activity.
There is a chance of stone recurrence, so regular follow-up is necessary.
The composition of food is related to stone formation, and a stone analysis report is required as dietary recommendations vary based on different stone compositions.
In Taiwan, urinary stones are classified into three main types: calcium oxalate stones, which are the most common and account for about 70% of urinary stones, often found as a mixture of calcium oxalate and a small amount of calcium phosphate; calcium phosphate and magnesium ammonium phosphate stones, which are associated with bacterial infections in urine, accounting for about 15%; and uric acid and cystine stones, which also account for approximately 15%.
Treatment methods depend on individual patient circumstances, including stone size, hardness, location, and severity.
Currently, less invasive methods such as ESWL and ureteroscopy are prioritized, followed by percutaneous nephrolithotomy (PCNL) and surgical intervention.
Non-invasive methods include:
- Extracorporeal shock wave lithotripsy (ESWL).
Minimally invasive methods include:
- Ureteroscopy.
- Cystolithotripsy.
- Percutaneous nephrolithotomy (PCNL).
Invasive methods include:
- Nephrolithotomy.
- Pyelolithotomy.
- Nephrectomy.
- Ureterolithotomy.
- Cystolithotomy.
Regarding stone prevention, if there are no restrictions on fluid intake, it is advisable to drink 3000-4000 cc of water daily, evenly distributed throughout the day (e.g., 200 cc every hour).
During hot weather, fever, diarrhea, or after exercise, fluid intake should be increased.
Drinking a glass of water before bed is recommended, as urine becomes concentrated during sleep, increasing the risk of stone formation.
(If waking up at night to urinate, drink another glass of water.
Nighttime urination should be limited to 1-2 times, without affecting sleep).
Avoid the habit of holding in urine.
Water is the best beverage, as most drinks contain oxalates.
Beer, with its slight alcohol content, has a diuretic effect that may help pass smaller stones, but it can also raise uric acid levels and contains oxalates, making it unbeneficial for stone patients in the long run.
The herbal remedy "Hua Shi Cao" (Plantago) has diuretic properties and can assist in passing small stones, but it is not a definitive treatment for urinary tract inflammation.

Regular check-ups for underlying metabolic disorders are essential.
Moderate exercise, such as jumping rope or using a hula hoop, is encouraged.
Patients should return to the stone clinic (every Tuesday afternoon) for follow-up, treatment, and to inquire about stone analysis results to further control stone formation.
If a Double-J stent is placed, it must be removed in a timely manner.
Medications prescribed, such as magnesium oxide (MgO), are intended to reduce calcium oxalate stones and also serve as a stool softener.
If mild diarrhea occurs, dosage should be reduced or temporarily discontinued.
Dietary recommendations for various types of stones:
For calcium oxalate stones:
- Reduce oxalate intake by minimizing high-oxalate foods such as tea, coffee, etc.
- Avoid excessive vitamin C intake.
- Increase vitamin B6 intake (as directed by a physician).
- Reduce calcium intake by avoiding excessive vitamin D.
- Avoid drinking hard water.
- Do not add vinegar when making bone broth, as it can leach calcium from bones.
- Limit high-calcium foods: milk, cheese, ice cream, yogurt, and dairy cakes.
- Reduce salt intake and eat a lighter diet.
For calcium phosphate stones:
- Limit high-phosphorus foods such as yeast and mushrooms.
- Reduce calcium intake.
For magnesium ammonium phosphate stones:
- Follow an acidic diet to control infection.
For uric acid stones:
- Follow an alkaline diet, take uric acid-lowering medications as prescribed, adhere to a low-purine diet, and limit alcohol consumption.
For cystine stones:
- Limit protein intake from fresh meat, poultry, fish, eggs, soy, peanuts, and wheat.
- Follow an alkaline diet and drink plenty of fruit juices (grapefruit juice, orange juice, cranberry juice, grape juice).
Note 1: High-oxalate foods include tea, black tea, coconut, coffee, cola, beer, cranberry juice, lemon, lentils, spinach, citrus fruits, grapes, apples, tomatoes, rhubarb, beets, okra, sweet potatoes, figs, plums, prunes, strawberries, almonds, chocolate, cocoa, peanuts, lettuce, celery, radishes, and asparagus.
Note 2: High-phosphorus foods include yeast, wheat germ, shrimp, mushrooms, whole grains, cereals, organ meats, egg yolks, milk, legumes, nuts, cocoa powder, chocolate, and juice powders.
Note 3: Acidic diet includes proteins, meat, poultry, fish, grains, grapes, watermelon, tomatoes, corn, asparagus, processed fruits, olives, plums, cranberries, and pumpkin.
Note 4: Alkaline diet includes milk, vegetables (especially legumes and green vegetables), most fruits, seaweed, halibut, salmon, eel, and beef.
Note 5: High-purine foods include saltwater fish (such as mackerel, small dried fish, sardines), organ meats (heart, liver, kidney, brain, spleen, intestines), gravies, broths, sausages, shiitake mushrooms, asparagus, legumes, yeast products (such as yogurt, sourdough, and health foods), chicken essence, scallops, clams, shrimp, and seaweed.
These foods should be consumed sparingly.

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Reply Date: 2008/06/05