Efficacy of mirabegron in medical expulsive therapy

Abstract

To show the efficacy of mirabegron for medical expulsive treatment, in patients had intramural located distal ureteral stone. A 80 patients had intramural ureteral stone were assessed retrospectively between April 2017 and January 2018. Mirabegron 50 mg/day + diclofenac 100 mg/day (group 1, n = 40), and only diclofenac 100 mg/day (group 2, n = 40) were administered to patients, consecutively. Age, gender, stone size, laterality, and severity of hydronephrosis were recorded. Spontaneous stone expulsion rates (SER), stone expulsion time, and the number of daily colic episodes were evaluated. In the group 1, one (2.5%) patient was excluded due to nasopharyngitis, and one (2.5%) patient was excluded due to 5 mmHg systolic blood pressure increase. In addition, four (10%) patients in group 1, and six (15%) patients in group 2, who did not attend follow-up examinations, were excluded from the study. There was not any statistically significant difference between the two groups in terms of age, gender, stone location, severity of hydronephrosis, stone size (p = 0.736, p = 0.310, p = 0.467, p = 0.801, p = 0.761, consecutively). Spontaneous expulsion ratios were calculated as 73.52% in group 1, and 47.05% in group 2 (p = 0.026). However, there was not any statistically significant difference in terms of stone expulsion time (p = 0.979). SER for patients had ≤ 6 mm stones was higher in group 1 (87.5 vs 52.49%, p = 0.031). In addition, group 2 patients had more pain episodes (1.02 ± 0.52 vs. 1.29 ± 0.57, p = 0.049). In the current study, mirabegron has been shown to be an efficient, safe and a new treatment modality, with lower side effect profile for the intramural located distal ureteral stones.

Can mirabegron facilitate ureteral access sheath placement during flexible ureterorenoscopy?

“…Animal experiments have also demonstrated dilatation of the ureter and a decrease in ureteral intraluminal pressure with the use of mirabegron [12]. In addition, it has been reported to be an effective and safe medical expulsive treatment agent for the reduction of distal ureteral stones with a low rate of side effects [4,14]. Mirabegron reduces the disturbing symptoms related to stents by dilatation of the ureter and decreasing intraluminal pressure [15].…”

“…[3] It relaxes the bladder's smooth muscle through beta-3 agonistic effects and thus has a wide range of uses in other diseases, such as distal ureteral stones. Mirabegron has been shown to facilitate stone expulsion, especially in cases of distal ureteral stones less than 0.5 cm [4]. In this study, we aimed to investigate whether mirabegron can facilitate the passage of UAS in f-URS procedures.…”

Hounsfield unit and its correlation with spontaneous expulsion of lower ureteric stone

“…Solakhan and colleagues studied the effect of mirabegron, a beta 3 agonist, and concluded that mirabegron is efficient, safe, and a new treatment modality with a lower side-effect profile for distal ureteral stones. 16…”

“…Solakhan and colleagues studied the effect of mirabegron, a beta 3 agonist, and concluded that mirabegron is efficient, safe, and a new treatment modality with a lower side-effect profile for distal ureteral stones. 16 Sfoungaristos and colleagues demonstrated in their study that smaller size, higher serum white blood cell (WBC) count, and the presence of ureteral jet were statistically significant predictors for spontaneous stone passage. 12 Total WBC count was found to be the most significant predictor, followed by the size of the calculus.…”

Mirabegron Role in Urolithiasis Management: What you should Know

“…They also showed less pain episodes (1.02 AE 0.52 versus 1.29 AE 0.57, p ¼ 0.049). 10 In contrast, Bayar et al recently published a prospective multicentric study with 169 patients included, all with ureter stones sized between 4 and 10 mm located proximally, medially or distally. They were divided into 3 groups by randomization: group 1 was the control group; group 2 took silodosin 8 mg/day, and group 3 took mirabegron 50 mg once daily.…”