Aim: The aim of this study was to compare the relative efficacies as well as side effects of the three  bladder smooth muscle relaxants, Darifenacin, Solifenacin and Tolterodine.

Methods: The study was a prospective randomised trial carried out in Surgery Department at M.L.N. Medical College, Allahabad from September 2010 to August 2013.

Results:  Mean age of patients suffering from OAB was 44 years. To decrease the number of micturition episodes, efficacy of Solifenacin > Tolterodine > Darifenacin. To decrease urgency, efficacy of Solifenacin = Tolterodine > Darifenacin. For mixed incontinence Solifenacin was better than both Darifenacin and Tolterodine. Regarding nocturia, efficacy of Solifenacin = Darifenacin > Tolterodine. Most common side–effects associated with these drugs were dry mouth, constipation and blurred vision but latter was significantly less with Solifenacin.

Conclusion: For treatment of overactive bladder Solifenacin can be suggested as the first line drug.