The erection should remain long enough for penetration and to allow the relationship until the ejaculation and also to allow the orgasm of the partner to approximately half the time. Ejaculation is a reflex triggered by stimulation of the penis. This reflex is automatic and every man is born with the characteristic to ejaculate quickly. Humans have learned that sex can be done as an act of love and pleasure, so learned to control the ejaculatory reflex, in order to prolong sexual intercourse. However, the ability to control this reflex undergoes numerous local influences, emotional and psychological. It is not possible to assess what the exact problem you are experiencing with you without examining you. Look for an urologist for further information.

Most prostate surgery does not cause impotence. The retrograde ejaculation occurs in about 75% of people operated. In the case of patients undergoing treatment for benign diseases, the probability of impotence is practically zero. In the case of patients operated for of the prostate cancer, the risk for impotency range from 30 to 100%, depending on the event (disease stage, tumor size, state of sexual function before the operation age). However, in any case erection that the patient has the sensation of orgasm remains practically the same. Only ejaculation is absent (in cancer) or is retrograde (in cases of benign disease).

Complex stones are becoming increasingly rare and with this therapy is becoming increasingly ambulatory (the patient does not need to be hospitalized). However, successful management requires competence in all aspects, from diagnosis, patient preparation, indication of the form of treatment to care postoperatively. The challenge today is to employ the optimal approach for each specific situation.
The Santa Casa de Misericórdia –ISCMPA- has today all the alternatives for use in the treatment of urinary tract calculations. We can mention:

1. Lithotripsy extracorporeal shock wave: the doctor locates the calculation with the aid of fluoroscopy or ultrasound, or both, and the machine breaks the calculation and the patient eliminates it through the urine into fragments like grains of sand.

2. Percutaneous intracorporeal lithotripsy: the doctor locates the calculation with a device fluoroscopy or ultrasound, puncture the kidney through the lumbar region with a needle, dilates the path and puts nephroscope lens that allows the visualization of the calculation, it breaks with the use ultrasound and remove the fragments.

3. Laparoscopic intracorporeal lithotripsy (used in complex cases): the physician performs a laparoscopy, enters the kidney collecting system (known as the renal pelvis) and removes the calculation, whole or fragmented.

4. Intracorporeal lithotripsy: for calculations of ureter (calculate it locked on the path between the kidney and bladder): the doctor locates the calculation Radioscopy and enters the ureteroscope through the urethra passes through the bladder and is consistent with the calculation. Apparatus which can be rigid, semi-rigid or flexible, with the use of one or the other will depend on the location and type of calculation. Uses an energy source to break it (ultrasonic, electro-hydraulic, pneumatic or laser) and then remove it. A feature often used in emergencial situations is to drain the kidney with the use of a catheter known as "Double J" which drain the kidney and the doctor has time to properly plan the best procedure. The "Double J" is for temporary use and should be removed always once the problem is solved.