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REMEDY : BNSSG referral pathways & Joint Formulary

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BNSSG Paediatric Joint Formulary

7.1 Bladder and urinary disorders

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7.1.1 Urinary frequency, enuresis, and incontinence

First line drugs Second line drugs Specialist drugs Secondary care drugs



First line:

Oxybutynin standard-release (TLS Amber Specialist Recommended)

Second line:

Oxybutynin modified-release (TLS Amber Specialist Recommended)

Tolterodine (standard-release & modified-release) (TLS Amber Specialist Recommended)

Third line:

Solifenacin (TLS Amber Specialist Recommended)

Oxybutynin (transdermal) (TLS Red)


Beta3-adrenoceptor Agonists

Mirabegron (TLS Amber 3 months)


Vassopressin Analogues

Desmopressin (oral tablets/oral lyophilisates) (TLS Green) 

For primary nocturnal enuresis



Botulinum toxin type A (TLS Red) 

  • For urinary incontinence/overactive bladder in children where oral antimuscarinic treatments have failed

See Botulinum Toxin A Pathways page for more information


7.1.2 Urinary retention

Alpha-adrenoceptor Blockers

Doxazosin (standard-release) (TLS Red)

Tamsulosin capsules (modified-release) (TLS Red)


7.1.3 Urological pain

Alkalinising Drugs

Potassium citrate (TLS Green)

Sodium bicarbonate (TLS Green)