OBJIECTIVE: To probe into the efficacy of mirabegron in medical expulsive therapy for distal ureteral calculus. METHODS: Patients diagnosed with distal ureteral calculus in Beijing Aerospace General Hospital from Jan.2019 to May 2020 were divided into group A（ diameter≤5. 0 mm） and group B（ diameter 5. 0-10. 0 mm） according to the diameter of calculus. Groups A and group B were divided into three groups（ A1

A2 and A3; B1

B2 and B3）via completely random method. Group A1 and group B1 were given mirabegron combined with diclofenac sodium

group A2 and group B2 were given tamsulosin hydrochlorid combined with diclofenac sodium

group A3 and group B3 were treated with diclofenac sodium. Except for the loss to follow-up and other treatment options

a total of 188 patients finally completed the research. Of which 95 cases in group A（ 33 cases in group A1

31 cases in group A2

31 cases in group A3）; 93 cases in group B（ 31 cases in group B1

30 cases in group B2

and 32 cases in group B3）. After 4 weeks of observation

differences in the rate of calculus removal

time of calculus removal

frequency of renal colic and score of bladder irritation were compared among the subgroups. RESULTS: The frequency of renal colic and score of bladder irritation of group A1 and group B1 were significantly lower than those of other subgroups in the same group

with statistically significant differences（ P < 0. 05）. The calculus-removal rate of group B1 was higher than that of group B3

with statistically significant difference（ P < 0. 05）; there was no statistical significance in difference in calculus-removal rates between group B1 and group B2（ P > 0. 05）. CONCLUSIONS: The application of mirabegron for patients with distal ureteral calculi with a diameter of less than 10. 0 mm can effectively improve the symptoms of bladder irritation and frequency of renal colic

which has better effect than that of tamsulosin hydrochloride; and mirabegron has increased the calculus-removal rate of distal ureteral calculus with diameter between5. 0-10. 0 mm.