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

Naftopidil is a specific alpha1D-adrenergic receptor antagonist. We performed the current randomized, controlled study to determine the expulsive role of naftopidil for distal ureteral stones.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 l 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.All patients in groups 1 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%, p0.01). 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 (p0.001).The selective alpha1D-blocker naftopidil can significantly facilitate spontaneous passage of distal ureteral stones with few side effects, providing a new choice for medical expulsive therapy.