This guidance is a partial update of National Institute for Health and Care Excellence (NICE) clinical guideline 40 (published October 2006) and will replace it.
New and updated recommendations have been included based on evidence of the clinical and cost effectiveness of: Antimuscarinic drugs: darifenacin, darifenacin – extended release, fesoterodine – modified release, oxybutinin, oxybutynin – modified release, oxybutynin – transdermal, oxybutynin – topical gel, propiverine, propiverine – extended release, solifenacin, tolterodine, tolterodine – extended release, trospium, trospium – extended release; Percutaneous sacral nerve stimulation (P-SNS) compared with either no active treatment or placebo; Percutaneous posterior tibial nerve stimulation (P-PTNS) compared with either no active treatment or placebo; Transcutaneous posterior tibial nerve stimulation (T-PTNS) compared with either no active treatment or placebo; Transcutaneous sacral nerve stimulation (T-SNS) compared with either no active treatment or placebo; A comparison of T-SNS, T-PTNS and P-PTNS (if these treatments are found to be effective compared with no treatment or placebo); Botulinum toxin A compared with placebo in women with overactive bladder (OAB) caused by detrusor overactivity; Pharmacological treatment compared with neuromodulation in all women with overactive bladder; Pharmacological treatment compared with neuromodulation and botulinum toxin A in women with OAB caused by detrusor overactivity only; Surgical approaches for mid-urethral procedures in women undergoing their primary surgical tape procedure: retropubic bottom up, retropubic top down, transobturator inside out, transobturator outside in, single incision; Interventions for women for whom the primary tape procedure has failed: conservative management, looking only at: lifestyle interventions, specifically weight loss, fluid management and smoking cessation and physical therapy, specifically pelvic floor muscle training, repeat tape procedure, fascial sling, colposuspension.
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Reference: London: Royal College of Obstetricians and Gynaecologists (UK); 2013 Sep.
PubMed Abstract
PMID: 25340217