AimsThe lack of a validated detrusor overactivity (DO) severity tool limits the clinical value of urodynamics in the management of patients with overactive bladder syndrome (OAB). The aim of this study, was to identify urodynamic variables that correlate with validated OAB severity measures. MethodsThis was a cross-sectional study enrolling consecutive women with idiopathic DO. The 24hr urgency episodes and the score of the Incontinence Impact (II) domain of the King's Health Questionnaire (KHQ) were used to assess the severity of OAB. ResultsThe study enrolled 299 women with idiopathic DO. The cystometric capacity, compliance, and the threshold volume for the first involuntary detrusor contraction (IDC) showed a statistically significant negative correlation with the II domain of the KHQ and the 24hr urgency episodes. There was a statistically significant positive correlation between the amplitude of first IDC and the OAB severity measures, but only borderline for the amplitude of the highest IDC. There were no statistically significant differences between women with and without leakage per urethram during a detrusor contraction. ConclusionsCystometric capacity, compliance (measured in ml/cm H2O), threshold volume, and amplitude of the first IDC could be routinely documented in everyday clinical practice. The measures more commonly used for describing the severity of DO, such as leakage per urethram during a detrusor contraction and amplitude of the highest detrusor contraction, have a limited role confirming the complicated interaction between the detrusor muscle, the urethral sphincter, and the pelvic floor in women. Neurourol. Urodynam. 36:780-783, 2017. (c) 2016 Wiley Periodicals, Inc.