Aims: The main objective of this study was to define urinary biomarkers that can predict the severity of overactive bladder and detect patients who would benefit most from treatment. Methods: Patients with an OAB diagnosis and healthy controls were included in the study. A bladder diary and a validated OAB questionnaire were given to all patients. In the OAB group, solifenacin 5mg daily was given for 1 month. Urine samples were taken before the treatment and after the first month of the treatment in both groups and urinary BDNF, NGF, GAG, and MCP-1 levels were measured. Results: A total of 45 OAB patients and 45 healthy age-matched controls were included. BDNF/Cre, NGF/Cre, MCP-1/Cre, and GAG/Cre levels were significantly higher in the OAB group. The levels of these biomarkers significantly decreased after 1 month of solifenacin treatment. After treatment, 66.7% of patients OAB symptoms were relieved and 33.3% did not respond to the treatment. Although basal biomarker levels did not differ between responder and non-responder groups, the ratio of decrease in biomarker levels was significantly higher in treatment-sensitive patients. Postmenopausal women were more resistant to treatment when compared with the premenopausal group. Conclusions: Urinary biomarkers have a role in the pathophysiology of OAB however they did not predict the patients who would benefit from the treatment and in whom antimuscarinics would be useless. Future studies with higher numbers of patients and different OAB subgroups are needed to investigate the exact role of these ( and other) biomarkers. (C) 2015 Wiley Periodicals, Inc.