The role of urinary urgency and its measurement in the overactive bladder symptom syndrome: current concepts and future prospects.
OBJECTIVE
To review the concept of urinary urgency and its practical measurement in clinical trials, and advance the hypothesis that while urge is experienced by normal people, urgency is always pathological.


METHODS
According to the International Continence Society (ICS) definition, urgency is the primary symptom of the overactive bladder (OAB) syndrome, but in clinical trials there are inconsistencies in both the definition and assessment of urgency. We searched the PubMed and BIOSIS databases for publications and abstracts related to the clinical assessment of urgency in patients with OAB.


RESULTS
The differentiation of urgency from the normal physiological desire to void is discussed. In clinical studies of OAB, urgency has been measured both qualitatively and quantitatively. Existing qualitative assessment scales for urgency are deficient in accuracy, validation or both, and are largely inconsistent with the currently accepted ICS definition of urgency. The quantitative assessment of urgency by diary entry has been validated and may be the most accurate, reproducible and clinically meaningful method available for measuring this variable.


CONCLUSIONS
Based on the existing ICS definition of urgency as 'a compelling desire to pass urine that is difficult to defer', the concept of qualitative assessment of urgency may be flawed.
Chapple
Christopher R
CR
Department of Urology, The Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. c.r.chapple@sheffield.ac.uk
Artibani
Walter
W
Cardozo
Linda D
LD
Castro-Diaz
David
D
Craggs
Michael
M
Haab
Francois
F
Khullar
Vik
V
Versi
Eboo
E
D002986:Clinical Trials as Topic; D003950:Diagnostic Techniques, Urological / Q000592:standards* / Q000639:trends; D005069:Evaluation Studies as Topic; D005544:Forecasting; D006801:Humans; D008499:Medical Records; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D001745:Urinary Bladder Diseases / Q000175:diagnosis*; D016055:Urinary Retention / Q000175:diagnosis*