Efficacy of silodosin or mirabegron in medical expulsive therapy for ureteral stones: a prospective, randomized-controlled study.

Abstract

To evaluate the efficacy of silodosin or mirabegron as a medical expulsive therapy for ureteric stones in adults. This is a prospective, randomized multicentric study. Patients who had ureter stones in size between 4 and 10mm were assessed prospectively. Patients were divided into three groups with equal randomization. Group 1 was the control group; group 2 took silodosin 8mg, and group 3 took mirabegron 50mg once daily. All 169 patients were included in the final analysis. The spontaneous expulsion rate was similar between groups. In patients with distal localization, the stone expulsion interval was shorter in the silodosin group (7.1 ± 4.5days) than the control (12 ± 8.7) (p = 0.034). In patients with stone size smaller than 6mm, the stone expulsion interval was shorter in the silodosin group (5.8 ± 4) than the control (12.2 ± 2.8) (p = 0.004); the analgesic requirement was less in the silodosin group (1.4 ± 1.3) than in the control (3.6 ± 2.8) (p = 0.028). Mirabegron had no effect on stone expulsion interval in any analysis. In patients with distal localization or stone size bigger or equal to 6mm, the need for an analgesic was less in the mirabegron group (1.8 ± 1.9) (1.9 ± 1.8) than in the control (3.6 ± 2.3) (3.2 ± 1.8), respectively (p = 0.004) (p = 0.017). Silodosin or mirabegron does not improve the stone expulsion rate. Silodosin improves the stone expulsion interval and decreases the need for an analgesic or < 6mm stones. Mirabegron has no effect on the stone expulsion interval, but decreases the need for an analgesic in patients with distal or sized ≥ 6mm stones.