Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Urol J. 2022 May 22;19(4):246-252. doi: 10.22037/uj.v19i.7119.
Several randomized-controlled trials (RCTs) were performed to compare the efficacy of sexual intercourse or masturbation and no sexual activity in treating distal ureteral stones, indicating conflicting results. The meta-analysis was conducted to assess the role of sexual intercourse or masturbation in the treatment of distal ureteral calculi.
PubMed, Cochrane Library, EMBASE, Scopus, Clinicaltrail.gov, and Web of Science were searched by October 2021. Men who were instructed of no sexual intercourse or masturbation, and only received standard symptomatic treatment are comparators. Relative risk (RR), weighted mean difference (WMD), and their 95% confidence intervals (CIs) were calculated using random or fixed effects models.
Five RCTs including 500 subjects were analyzed in the study. Compared with controls, subjects in experimental group had significantly higher expulsion rate at 2nd and 4th week (95%CI: 1.334 to 2.638, RR: 1.876, I2 = 73.6%, P < .001; 95%CI: 1.148 to 1.752, RR: 1.418, I2 = 55.9%, P < .001), significantly decreased requirement for analgesic injections (95%CI: -1.071 to -.126, WMD: -.598, I2 = 90.3%, P = .013), and significantly shorter expulsion time (95%CI: -6.941 to -.436, WMD: -3.689, I2 = 83.7%, P = .026).
Performing sexual intercourse or masturbation 3 or 4 times a week can be an alternative treatment option of distal ureteral calculi (0-10 mm in size). However, more clinical evidence with better designs solving raised concerns is warranted.
多项随机对照试验（RCT）比较了性行为或自慰与无性行为治疗远端输尿管结石的疗效，结果存在争议。本荟萃分析旨在评估性行为或自慰在治疗远端输尿管结石中的作用。
检索 PubMed、Cochrane Library、EMBASE、Scopus、Clinicaltrail.gov 和 Web of Science，截至 2021 年 10 月。对照组为未行性行为或自慰指导、仅接受标准对症治疗的患者。采用随机或固定效应模型计算相对危险度（RR）、加权均数差（WMD）及其 95%置信区间（CI）。
纳入的 5 项 RCT 共 500 例患者。与对照组相比，实验组第 2 周和第 4 周排石率显著更高（95%CI：1.334 至 2.638，RR：1.876，I² = 73.6%，P <.001；95%CI：1.148 至 1.752，RR：1.418，I² = 55.9%，P <.001），镇痛药物注射需求显著减少（95%CI：-1.071 至 -.126，WMD：-0.598，I² = 90.3%，P =.013），排石时间显著缩短（95%CI：-6.941 至 -.436，WMD：-3.689，I² = 83.7%，P =.026）。
每周进行 3 或 4 次性行为或自慰可能是治疗大小为 0-10mm 的远端输尿管结石的一种替代治疗方法。然而，需要更多设计更好的临床试验证据来解决提出的问题。
