Overactive bladder syndrome(OAB) is defined as a group of symptoms with or without frequent urinary incontinence in the absence of an infection or other obvious pathologies, often with complaints of frequent urination and urinary urgency (day and night) along with or without urge incontinence. The aim of this study is to assess the validity and reliability of Turkish version? overactive bladder – V3 (OAB-V3) and to evaluate the results of behavioral management with OAB-V3.

The study was carried out with 90 patients who applied to our?outpatient clinic between October 2020-April 2021. OAB-V3 Turkish validation was developed from the English version. Demographic data of the patients were recorded. Patients referred to functional urology clinic with OAB symptoms were included in the study. In order for the patients to be included in the study, they were required to read and write in Turkish, to understand what they read and to be over 18 years of age. Patients who were under 18 years of age, received active OAB medication?, cannot read and write Turkish, cannot understand what they read, and did not agree to participate in the study were excluded. The demographic characteristics of the patients were recorded and their physical examinations were performed. Patients filled in the OAB-V3 Turkish form consisting of 3 questions, Overactive bladder questionnaire form (OAB-v8) and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). 3-day urinary diaries of the patients were recorded and 24 hour pad test was performed. The patients filled out the same forms again after 2 weeks. The group receiving behavioral management within these patients filled out the OAB-V3-Turkish again after 8 weeks. Behavioral management consisted of bladder training, patient education about OAB and lifestyle modifications. Bladder training was a program led by a trained nurse for patients to gradually increase voiding intervals with weekly arrangements for 8 weeks.

A total of 60 OAB patients and 30 healthy control, including 30 OAB-wet and 30-OAB dry, were included in the study. The mean age of the patients was 56.32±11.44 (28-77) years, the mean BMI was 35.53±7.24 (23.74-45.79) and the mean duration of OAB complaint was 54.32±37.73 (12-180) months. The mean score of the OAB-V3 was 7.99±3.40, OAB-V8 was 19.78±5.06 and mean score of the ICIQ-SF was 12.90±4.73. The results of the reliability assessment showed that the intraclass correlation coefficient of the total OAB-V3 score was 0.822 (weighted coefficients of individual item points, 0.739-0.882), and the Cronbach α was 0.817. Test-retest reliability was 0.689. In the validity analysis, the OAB-V3 total score was highly correlated with that belonging to other questionnaire forms (OAB-v8, ICIQ-SF and bladder diary). The mean total OAB-V3 scores of the 30 patients receiving behavioral management decreased from 7.89±3.29 to 5.86±2.56 (p<0.001). The same decrease was observed in OAB-V8 and ICIQ-SF scores (p<0.001 for OAB-v8 and p=0.001 for ICIQ-SF). This improvement in symptom scores was also observed in bladder diary values. 
Table: OAB-V3 Scores of the patients
OAB-V3	       Mean±SD	Min-Max
Ouestion-1	2.92±1.30	1-5
Question-2	2.24±0.96	0-4
Question-3	3.15±1.27	2-5
Total	        7.99±3.40	0-13

In this study, the validity and reliability of the Turkish version of OAB-V3 were evaluated using the data collected from OAB patients residing in Turkey. For assessing the reliability, the test-retest reliability and internal consistency(ICC) of OAB-V3 were evaluated. The ICC for this study was more than 0.7 (0.822), which provided a sufficient condition for clinical trials. For each item in OAB-V3, weighted Kappa coefficients ranging from 0.54 to 0.78 were found. For internal consistency, a Cronbach α value of 0.817 was calculated and it was determined that the survey was valid. The value of Cronbach α depends on the correlations between the items and the number of items in the questionnaire.

The OAB-V3-Turkish version has been developed and approved as a reliable tool for evaluating patients with OAB. This study showed that behavioral management is one of the  effective treatment modality in the treatment of OABS, urinary frequency, urge incontinence and for improving OAB-V3, OAB-v8 and ICIF-SF scores. This simple questionnaire is expected to be useful in clinical studies and medical applications among Turkish-speaking OAB patients.