Efficacy of Selective α1D-Blocker Naftopidil as Medical Expulsive Therapy for Distal Ureteral Stones

Purpose: Naftopidil is a specific alpha 1D-adrenergic receptor antagonist. We performed the current randomized, controlled study to determine the expulsive role of naftopidil for distal ureteral stones. Materials and Methods: From March 2006 to January 2007, 60 patients with distal. ureteral stones were randomly divided into groups 1 and 2. Group 1 served as the control and underwent watchful waiting, while group 2 received 50 mg naftopidil daily in the morning. All patients were instructed to drink a minimum of 2 1 water daily. The stone expulsion rate and time, potential side effects of naftopidil, number of pain episodes and requirements for pain medication were documented during the 14-day followup. Results: All patients in groups I and 2 completed the study. There was no difference between the groups in patient age, sex and stone size. The stone expulsion rate was significantly higher in group 2 than in group 1 (90.0% vs 26.7%; p <0.01). No significant difference in expulsion time was noted between the groups. No patients experienced obvious naftopidil side effects or ureteral colic. Multivariate analysis using a Cox proportional hazards model indicated that the probability of expulsion was increased 5.263 times (95% CI 2.304-12.024) in group 2 compared with that in group 1 (p <0.001). Conclusions: The selective alpha 1D-blocker naftopidil can significantly facilitate spontaneous passage of distal ureteral stones with few side effects, providing a new choice for medical expulsive therapy.