An observational study on the efficacy of mirabegron in medical expulsive therapy of the lower ureteric calculus

Abstract

Purpose: Medical expulsive therapy (MET) is used in lower ureteric calculus to reduce symptoms, to facilitate passage, and to decrease the requirement of endourological surgical interventions. Alpha-blockers, spasmolytics, and calcium channel blockers have been shown to be effective in clinical trials. Beta-3 receptor stimulation in the ureter has been shown to decrease the intraluminal pressure. Thus, Mirabegron, beta 3 receptor agonist, can be thought as alternative MET agent. Materials and Methods: We have done prospective observational study to see the efficacy of mirabegron for MET of lower ureteric calculus ≤10 mm in size. Patients were divided into two groups: Group A (n = 50) received diclofenac 50 mg twice daily for 5 days then on demand for 4 weeks and Group B (n = 50) received diclofenac 50 mg twice daily for 5 days than on demand and mirabegron 50 mg daily for 4 weeks. Patients were followed up weekly with clinical examination, ultrasound screening of kidney, ureter, and bladder (KUB) and noncontrast computed tomography scan KUB after the 28th day of therapy. Results: We found that the passage of stone is significantly higher in mirabegron group (Group A: 68% and Group B: 92%; P