Exploratory clinical and urodynamic changes associated with mirabegron-containing multimodal treatment in children with non-monosymptomatic nocturnal enuresis: a retrospective real-world study.

Background: Evidence regarding mirabegron-containing treatment for children with non-monosymptomatic nocturnal enuresis (NMNE) is limited, and its independent effects require controlled evaluation. Objective: To describe exploratory clinical and urodynamic changes observed after mirabegron-containing multimodal treatment in children with NMNE. Methods: We retrospectively reviewed 31 children with NMNE who received mirabegron-containing treatment at the outpatient clinic of West China Hospital of Sichuan University between July 2024 and March 2025. Mirabegron was added to first-line treatment when voiding diaries suggested reduced functional bladder capacity. Patients received 25 or 50 mg once nightly according to age and weight for 12 weeks, without dose adjustment. Voiding diary parameters and available urodynamic measurements were compared before and after treatment. Results: After 12 weeks, voiding frequency, daytime incontinence episodes, and nocturnal enuresis episodes decreased, while maximum voided volume increased. Maximum cystometric capacity was measured before and after treatment in all 31 patients and showed a modest within-cohort increase. Follow-up measurements of detrusor pressure at the end of filling and bladder compliance were available for only four patients. These descriptive data showed lower detrusor pressure and higher bladder compliance after treatment. Based on nocturnal enuresis episode reduction, 28 of 31 patients (90.3%) met the predefined diary-based improvement threshold. This proportion cannot be interpreted as a pharmacologic response attributable to mirabegron because treatment was multimodal and uncontrolled. No treatment-related adverse events were documented, but retrospective records are insufficient to establish safety. Conclusion: Mirabegron-containing multimodal treatment was associated with within-cohort changes in voiding diary parameters and a modest increase in maximum cystometric capacity. The retrospective, single-arm design precludes causal or treatment-specific inference, and patient-centered outcomes were not assessed. These findings are preliminary, exploratory, and hypothesis-generating rather than practice-informing.