Urge Perception Index of Bladder Hypersensitivity

Purpose: By analyzing bladder diaries with patient self-reported urinary perception grades, we developed the urge perception index, a quantitative measure of bladder hypersensitivity. We evaluated the impact of the urge perception index on the definition of overactive bladder severity. Materials and Methods: We retrospectively evaluated the records of 69 female patients who visited our outpatient clinic with the complaint of storage symptoms. Patients were asked to complete the overactive bladder symptom score and a 3-day bladder diary with self-reported grading of urinary perception on a range of 1 to 5 per void. Overactive bladder was diagnosed in 43 patients and nonoveractive bladder was diagnosed in 26. The urge perception index was defined as voided volume divided by the urinary perception grade at each void. Results: We analyzed 1,578 reported voids. According to the urinary perception grade, urge perception index values for overactive bladder were significantly lower than those for nonoveractive bladder (grades 1 to 4 p <0.001). The average +/- SD urge perception index in 3-day bladder diaries was lower in overactive than in nonoveractive bladder cases (55 +/- 28 vs 133 +/- 73, p <0.0001). The most severe (lowest) single urge perception index value during the 3 days was significantly lower in patients with overactive than with nonoveractive bladder (mean 20 +/- 12 vs 62 +/- 40, p <0.0001). There were negative linear correlations of the urge perception index with total overactive bladder symptom scores (r = -0.598, p <0.0001) and with an urgency symptom score (r = -0.557, p <0.0001). Conclusions: The urge perception index, an integrated parameter of patient reported bladder perception and voided volume, could be promising to quantify the severity of overactive bladder or bladder hypersensitivity by bladder diary analysis.