When trying to diagnose the type of incontinence that you or the person you care for is experiencing, and the level of severity, often your health professional may ask you to complete a Bladder Diary.
The International Continence Society (ICS) have products two very comprehensive Bladder Diaries (one for Males and one for Females) that you may choose to use a template. These are featured below.
How to Complete your Bladder Diary
Time: Indicate the time you woke and slept. When you have a drink or pass urine, write down the volume in the appropriate column against the relevant time.
Bladder Sensation: Use the following codes to describe how your bladder felt when you went to the toilet: No sensation of needing to pass urine, but passed urine for ‘social reasons’ e.g. just before going out, or unsure where the next toilet is. Normal desire to pass urine and no urgency. Urgency but it had passed away before you had to visit the toilet. Urgency but managed to get to the toilet, still with urgency, but did not leak urine. Urgency and could not get to the toilet in time so leaked urine. Urgency is different from normal bladder feelings and is the sudden compelling desire to pass urine which is difficult to defer, or a sudden feeling that you need to pass urine and if you don’t you will have an accident.
Drinks: Record the amount and type of drink when consumed.
Urine Amount: Record the amount of urine you passed in millilitres (ml) using a measuring jug. If you passed urine but couldn’t measure it, put a tick in this column. If you leaked urine at any time write LEAK here.It is not essential to complete the Drinks column; the Urine Amount column is the most important.
Pads: If you change a pad put a tick in this column.
Female Questionnaire & Bladder Diary