Urgency warning time and urgency frequency represent distinct dimensions of urinary urgency: a nationwide study from the Japan Community Health Survey 2023.

PURPOSE: Urinary urgency is commonly evaluated by frequency. However, urgency warning time-the ability to defer voiding after urgency onset-has been proposed as a pragmatic clinical measure and potential treatment target. This study compared urgency warning time and frequency as distinct dimensions of urinary urgency and examined determinants and impact on daily life in a nationwide population. METHODS: This cross-sectional study analyzed 1,801 individuals reporting urinary urgency in the 2023 Japan Community Health Survey. Urgency warning time and frequency were assessed using categorical self-reported measures. Multivariable logistic regression identified independent predictors of shorter warning time (≤ 5 min) and higher frequency (≥ once per day). Associations with impact on daily life were also evaluated, including stratified analyses by urgency frequency. RESULTS: Urgency warning time and frequency were significantly associated but demonstrated distinct demographic and clinical profiles. Shorter warning time was independently associated with older age, poorer performance status, decline in walking speed, spinal disease, obstructive sleep apnea syndrome, and fecal incontinence. Higher urgency frequency was associated with male sex, poorer performance status, ischemic cardiac disease, and spinal disease. In stratified analyses, shorter warning time was consistently associated with greater impairment in daily life, regardless of urgency frequency. In multivariable models incorporating lower urinary tract symptoms, higher urgency frequency and shorter warning time remained independently associated with impaired daily life. CONCLUSIONS: Urgency warning time and frequency represent related but distinct dimensions of urinary urgency, with different determinants and independent contributions to impaired quality of life. Assessing warning time may enhance clinical urgency evaluation beyond frequency-based measures.