Update on drugs for overactive bladder syndrome

Around 1.5% of adults in Europe and the USA have urge urinary incontinence (involuntary leakage immediately preceded or accompanied by urgency). This is usually due to overactive bladder syndrome (defined as urgency, with or without urge incontinence, and usually with frequency and nocturia), which occurs in around 12% of adults, and is similarly prevalent in men and women. We last reviewed this condition in 2001. Since then, two new antimuscarinic drugs, darifenacin (Emselex) and solifenacin (Vesicare) have been licensed in the UK for urge incontinence and/or increased urinary frequency and urgency (as may occur in patients with overactive bladder syndrome), as have transdermal oxybutynin (Kentera) and modified-release formulations of tolterodine (Detrusitol XL) and propiverine (Detrunorm XL). Here we review the place of these newer drugs and formulations.