Objective To compare the clinical efficiency and safety of emergency extracorporeal shock wave lithotripsy (eESWL) and delayed extracorporeal shock wave lithotripsy (dESWL) in the treatment of ureteral stones. Methods Cochrane Library, PubMed, Google Scholar, and Web of Science were searched from January 1, 1992 to September 30, 2022, and all comparative studies involving eESWL and dESWL for ureteral calculi were included. Statistical analysis was performed using Review Manager 5.3 software. Funnel plot was used to evaluated publication bias. Results A total of 9 articles involving 976 patients diagnosed with ureteral stones were included. The results showed that the stone-free rate (SFR) after four weeks was significantly higher in the eESWL group than in the dESWL group [relative risk (RR) = 1.22, 95% confidence interval (CI): 1.13–1.32, P < 0.01]. In subgroup analysis of different stone locations, proximal ureteral calculi [RR = 1.25, 95% CI: 1.14–1.38, P < 0.01] and mid-to-distal ureteral calculi [RR = 1.18, 95% CI: 1.03–1.34, P < 0.05] all showed a higher SFR in the eESWL group. eESWL significantly shortened the stone-free time(SFT) [mean difference (MD) = -5.75, 95% CI: -9.33 to -2.17, P < 0.01]. In addition, eESWL significantly reduced auxiliary procedures [RR = 0.53, 95% CI: 0.40–0.70, P < 0.01]. No significant difference in complications was found between the two groups [RR = 0.90, 95% CI: 0.69–1.16, P > 0.05]. Conclusion eESWL can significantly improve SFR, shorten SFT, and reduce auxiliary procedures.

Background: A meta-analysis was conducted to study the efficacy of sexual stimulation during the conservative treatment of distal ureteral stones. Methods: All randomized controlled trials (RCTs) devoted to comparing the efficacy of sexual stimulus and placebo in treatment of distal ureteral stones were searched from PubMed, Web of Science, Cochrane Library and Google Scholar. The retrieval time ranged from the inception to December 31, 2021. RevMan 5.3 software was used to conduct the statistical analysis. Clinical efficacy was evaluated by the stone passage rate and time and analgesic use. Results: A total of 6 RCTs comprising 535 cases of distal ureteral stones were included. 273 cases were associated with sexual intercourse or masturbation 3-4 times a week, and 262 cases received only conventional medical treatment. The pooled results showed that the 2-week (RR = 1.77, 95% CI [1.34, 2.33]) and 4-week (RR = 1.48, 95% CI [1.29, 1.69]) expulsion rates of the intervention group were significantly higher than in the control group (ps<0.01). Additionally, sexual stimulation was associated with a shorter expulsion time (WMD = -3.74, 95% CI [-6.27, -1.22], p<0.01) and a decreased prevalence of renal colic attacks (WMD = -0.61, 95% CI [-1.01, -0.22], p<0.01). Conclusion: Proper sexual stimulation, such as sexual intercourse or masturbation 3-4 times weekly, can enhance the spontaneous expulsion of distal ureteral stones in patients presenting tolerable pain.

Objective To compare the clinical efficiency and safety of emergency extracorporeal shock wave lithotripsy (eESWL) and delayed extracorporeal shock wave lithotripsy (dESWL) in the treatment of ureteral stones. Methods Cochrane Library, PubMed, Google Scholar, and Web of Science were searched from inception to September 30, 2022, and all comparative studies involving eESWL and dESWL for ureteral calculi were included. Statistical analysis was performed using Review Manager 5.3 software. Results A total of 9 articles involving 976 patients diagnosed with ureteral stones were included. The results showed that the stone-free rate (SFR) after four weeks was significantly higher in the eESWL group than in the dESWL group [odds ratio (OR) = 2.19, 95% confidence interval (CI): 1.62–2.96, P < 0.01]. In subgroup analysis of different stone locations, proximal ureteral calculi [OR = 2.37, 95% CI: 1.66–3.38, P < 0.01] and mid-to-distal ureteral calculi [OR = 2.47, 95% CI: 1.23–4.97, P < 0.05] all showed a higher SFR in the eESWL group. eESWL significantly shortened the stone-free time(SFT) [mean difference (MD) = -5.75, 95% CI: -9.33 to -2.17, P < 0.01]. In addition, eESWL significantly reduced auxiliary procedures [OR = 0.45, 95% CI: 0.32–0.64, P < 0.01]. No significant difference in complications was found between the two groups [OR = 0.84, 95% CI: 0.56–1.27, P > 0.05]. Conclusion eESWL can significantly improve SFR, shorten SFT, and reduce auxiliary procedures.