7.4.2 Drugs for urinary frequency, enuresis, and incontinence

General Guidance

Click here for Dudley Guidelines for  Promotion of Urinary Continence in Females and of Lower Urinary Tract Symptoms (LUTS) in Males

• ​Pelvic floor exercises and behavioural therapy are effective treatment options for managing stress and urge incontinence.
• Antimuscarinics drugs can be useful in the treatment of urinary frequency but may be associated with unpleasant adverse effects.
• Propantheline has a low response rate with a high incidence of adverse effects – its use should be avoided.

Please note Versomni is no longer formulary, however whilst the guidance is being updated, the current guidance remains active except for the section on Versomni.

Recommended drugs

Oxybutynin tablets standard and modified release ££

Tolterodine standard and modified release £££

Fesoterodine modified-release £££ - To be used 2nd line if unsuccessful with tolterodine in line with local guidelines

Solifenacin £££

Solifenacin with tamsulosin hydrochloride (Vesomni)  £££

Trospium £££

Duloxetine £££

Oxybutynin transdermal patch (for patients unable to tolerate oral agents £££

Meatal Dilators (Prescribed following the recommendation of Continence Team)

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low