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Development and psychometric evaluation of the urgency questionnaire for evaluating severity and health-related quality of life impact of urinary urgency in overactive bladder

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Introduction and hypothesis

Urinary urgency is the cardinal symptom of overactive bladder (OAB). However, there is no single instrument that assesses the context, severity, intensity, and daily life impact of urinary urgency. The purpose of this manuscript is to describe the methods and results of the qualitative and quantitative research conducted to develop a new tool for this purpose, the Urgency Questionnaire (UQ).


Qualitative data from interviews with patients with urinary urgency were used to develop and refine the items and response options of the UQ. Three studies were used to evaluate psychometric properties: a clinical trial of tolterodine (Detrol; n = 974); a psychometric validation study (n = 163); and a test–retest validation study (n = 47). Item and exploratory factor analysis (EFA) were performed to assess the subscale structure, and the psychometric performance of the resulting scales was evaluated.


Fifteen Likert-scale items and four VAS questions were retained. A four-factor solution was shown to best fit the data, with the subscales: Impact on Daily Activities, Time to Control Urgency, Nocturia, and Fear of Incontinence. All subscales and VAS items demonstrated good reliability (Cronbach’s α 0.79–0.94), convergent and discriminant validity, and responsiveness to change. The UQ differentiated between OAB patients and controls.


The results provide quantitative evidence that urinary urgency, as assessed by the UQ, is a pathological sensation distinctive from the normal urge to void and suggest that the UQ might be a reliable, valid, and responsive instrument for evaluating the severity and HRQL impact of urinary urgency in OAB.

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Funding for this work was provided by Pfizer.

Conflicts of interest

Karin S. Coyne, Chris C. Sexton, and Christine Thompson are employed by Evidera (formerly United Biosource Corporation), which provides consulting and other research services to pharmaceutical, device, government, and nongovernment organizations. As Evidera employees, they work with a variety of companies and organizations and are expressly prohibited from receiving any payment or honoraria directly from these organizations for services rendered. Tamara Bavendam has equity interests with Pfizer. Linda Brubaker does not have any conflicts at this time. Karin S. Coyne, Chris C. Sexton, and Christine Thompson were paid consultants to Pfizer in connection with the development of this manuscript.

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Correspondence to Karin S. Coyne.

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Coyne, K.S., Sexton, C.C., Thompson, C. et al. Development and psychometric evaluation of the urgency questionnaire for evaluating severity and health-related quality of life impact of urinary urgency in overactive bladder. Int Urogynecol J 26, 373–382 (2015).

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