OBJECTIVES: Urinary urgency is a central symptom of overactive bladder (OAB) and is particularly bothersome due to its unpredictable nature and consequent impact on daily living. There are no objective clinical measures of urgency and there is a need for a validated, standardized instrument. The purpose of this study was to ascertain the validity and responsiveness of the Urgency Perception Scale (UPS) as an indicator of perceived urinary urgency. METHODS: Content validity was assessed by interviews with OAB patients and clinical experts. Secondary analyses of clinical and patient outcome data gathered from three separate clinical studies of tolterodine extended release were performed to evaluate the psychometric properties of the UPS. Construct validity was assessed by correlations between the UPS and micturition diaries and other patient-reported outcomes including perception of bladder condition, perception of treatment benefit, SF-36, King's Health Questionnaire, Overactive Bladder Questionnaire, and Overall Treatment Effect scale. Analysis of variance was used to assess the UPS's construct validity and responsiveness. RESULTS: The UPS was considered an appropriate and reasonable assessment of urinary urgency by patients (n=16) and clinicians (n=7). Data from a total of 2,686 patients from three clinical studies were analyzed; the baseline clinical and demographic characteristics were similar among the three patient samples. Correlations with patient outcomes and clinical variables were small to moderate (0.09 to 0.46, p <0.01) with higher correlations associated with disease-specific patient outcome measures. Responsiveness was supported by improvements in the UPS score at the end of treatment which were consistently associated with significant (p<0.05) reductions in micturitions associated with urgency, incontinence episodes, and pad use. CONCLUSION: The UPS is a conceptually valid scale with evidence of construct validity and responsiveness from three clinical studies. This work demonstrates that perceived urinary urgency and changes in urinary urgency can be assessed.