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Objective <p>To evaluate the clinical outcomes associated with mirabegron as adjunctive medical expulsive therapy after extracorporeal shock wave lithotripsy (ESWL) for 6–10&#xa0;mm distal ureteral stones.</p> Methods <p>We retrospectively analyzed patients with distal ureteral stones (6–10&#xa0;mm in diameter) who had undergone extracorporeal shock wave lithotripsy (ESWL) between January 2023 and January 2025. Patients were categorized according to the post-ESWL medication documented in their medical records: mirabegron 50&#xa0;mg once daily, tamsulosin 0.4&#xa0;mg once daily, or vitamin C 100&#xa0;mg once daily as the control treatment. Urinary urgency and pain were assessed using the Urinary Sensation Scale (USS) and the Visual Analogue Scale (VAS), respectively. Patients were followed until stone expulsion or for up to 4 weeks.</p> Results <p>A total of 165 patients were included: 53 in the mirabegron group, 57 in the tamsulosin group, and 55 in the control group. At 1 week, the stone-free rate (SFR) was higher in the mirabegron group (47.2%) than in the tamsulosin (28.1%) and control groups (14.5%). At 2 weeks, SFR did not differ between mirabegron and tamsulosin (64.2% vs. 66.7%), while both remained higher than control (40.0%). By 4 weeks, SFR was similarly high across groups (94.3%, 96.5%, and 94.5%, respectively). The pre-treatment VAS and USS scores showed no difference among groups. However, the post-treatment VAS and USS scores were significantly lower in the mirabegron group than in the tamsulosin group (<i>P</i> &lt; 0.01).</p> Conclusion <p>Mirabegron use was associated with earlier stone fragment clearance and better relief of renal colic and irritative urinary symptoms after ESWL compared with tamsulosin, whereas the final 4-week stone-free rates were similar. These findings require confirmation in prospective randomized studies.</p>

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Mirabegron for accelerating passage of 6–10 mm distal ureteral stones after extracorporeal shock wave lithotripsy: a retrospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年7月29日

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  • Xiang Hu,
  • Yue-guang Zhao,
  • Jun-jie Shu,
  • Hai-ou Lv,
  • Yu-han He

摘要

Objective

To evaluate the clinical outcomes associated with mirabegron as adjunctive medical expulsive therapy after extracorporeal shock wave lithotripsy (ESWL) for 6–10 mm distal ureteral stones.

Methods

We retrospectively analyzed patients with distal ureteral stones (6–10 mm in diameter) who had undergone extracorporeal shock wave lithotripsy (ESWL) between January 2023 and January 2025. Patients were categorized according to the post-ESWL medication documented in their medical records: mirabegron 50 mg once daily, tamsulosin 0.4 mg once daily, or vitamin C 100 mg once daily as the control treatment. Urinary urgency and pain were assessed using the Urinary Sensation Scale (USS) and the Visual Analogue Scale (VAS), respectively. Patients were followed until stone expulsion or for up to 4 weeks.

Results

A total of 165 patients were included: 53 in the mirabegron group, 57 in the tamsulosin group, and 55 in the control group. At 1 week, the stone-free rate (SFR) was higher in the mirabegron group (47.2%) than in the tamsulosin (28.1%) and control groups (14.5%). At 2 weeks, SFR did not differ between mirabegron and tamsulosin (64.2% vs. 66.7%), while both remained higher than control (40.0%). By 4 weeks, SFR was similarly high across groups (94.3%, 96.5%, and 94.5%, respectively). The pre-treatment VAS and USS scores showed no difference among groups. However, the post-treatment VAS and USS scores were significantly lower in the mirabegron group than in the tamsulosin group (P < 0.01).

Conclusion

Mirabegron use was associated with earlier stone fragment clearance and better relief of renal colic and irritative urinary symptoms after ESWL compared with tamsulosin, whereas the final 4-week stone-free rates were similar. These findings require confirmation in prospective randomized studies.