Pharmacological treatment for overactive bladder (OAB) is indicated in patients who have symptoms such as urgency, increased micturition frequency, and/or urgency incontinence, particularly when non-pharmacological management has been insufficient or ineffective NICE CKS.
Offer antimuscarinic drugs to people with spinal cord disease and symptoms of OAB, such as increased frequency, urgency, and incontinence NICE CKS.
If antimuscarinic treatment is contraindicated, clinically ineffective, or causes unacceptable adverse effects, consider beta-3 adrenergic receptor agonists like mirabegron or vibegron NICE CKS,NICE CKS.
In cases where detrusor overactivity is confirmed via urodynamic investigation and symptoms persist despite non-surgical management, pharmacological treatment is indicated, with options including antimuscarinics or beta-3 adrenergic receptor agonists NICE NG123.