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RESEARCH ARTICLE

Real-world efficacy and tolerability of solifenacin for the treatment of neurogenic overactive bladder in patients with multiple sclerosis

Luca Orecchia1† ,  Eleonora Rosato1†* ,  Petra Vogrig1 ,  Daniele Bianchi2 ,  Yuri Cavaleri2 ,  Giorgia Mataluni3 ,  Doriana Landi3 ,  Maddalena Dal Pozzo3 ,  Carolina Gabri Nicoletti3 ,  Girolama Alessandra Marfia3 ,  Enrico Finazzi Agrò1,2,3
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1 Urology Unit, Department of Surgical Sciences, Policlinico Tor Vergata, Rome 00122, Italy
2 School of Specialization of Urology, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome 00133, Italy
3 Multiple Sclerosis Clinical and Research Unit, Policlinico Tor Vergata University Hospital, University of Rome Tor Vergata, Rome 00133, Italy
Bladder, e21200084 https://doi.org/10.14440/bladder.0353
Submitted: 29 October 2025 | Revised: 19 January 2026 | Accepted: 26 January 2026 | Published: 6 March 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Evidence on the use of antimuscarinic agents, such as solifenacin, for the treatment of neurogenic overactive bladder (nOAB) in patients with multiple sclerosis (MS) mainly derives from small, selected populations or industry-sponsored trials. Real-world data on its effectiveness and tolerability in unselected MS cohorts remain limited. Objective: The aim of this study is to evaluate the efficacy and safety of solifenacin in a real-world population of MS patients managed in an outpatient setting. Methods: We conducted a retrospective analysis of consecutive MS patients treated with solifenacin at any point in their urological treatment course. Demographic, clinical, and urodynamic data were collected, including lower urinary tract symptoms (LUTS), uroflowmetry parameters, and treatment-related adverse drug reactions. Results: Seventy-four patients were included, of whom 71.6% were female, with a mean age of 49 ± 10.7 years. Solifenacin was prescribed as first-line therapy in 82.4% of cases. During treatment, resolution of nOAB symptoms was achieved in 63.5% of patients, while urge urinary incontinence decreased to 35.1% during treatment. Uroflowmetry parameters and post-void residual volumes remained stable, indicating a negligible impact on voiding efficiency. Fourteen mild adverse drug reactions were reported, which were mainly constipation and transient urinary retention. Conclusion: This study confirms that solifenacin is an effective and well-tolerated treatment for nOAB in MS patients, with a favorable safety profile and minimal impact on bladder emptying. Unlike previous studies based on highly selected populations, our results provide pragmatic evidence from everyday clinical practice, supporting solifenacin as a reliable first-line option in neurogenic LUTS management among MS patients.

Keywords
Multiple sclerosis
Neurogenic overactive bladder
Solifenacin
Antimuscarinic agents
Real-world data
Lower urinary tract symptoms
Funding
None.
Conflict of interest
All authors declare no conflicts of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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