Bladder health
Bladder diary
How to keep a bladder diary, an example, and a blank diary you can print.
The main purpose of a bladder log is to document how your bladder functions. A log gives your health care provider an excellent picture of your bladder habits and patterns. At first it is used as an evaluation tool. Later, it measures your progress with bladder retraining or leakage episodes.
Complete a bladder log every day for the number of days your provider recommends, and bring it to your appointment. Fill it out as you go through the day. It is very hard to remember at the end of the day exactly what happened in the morning.
How to fill it in
- Column 1: Time of day
- The log begins at midnight and covers 24 hours. Choose the hour block that matches the time you are recording.
- Column 2: Type and amount of fluid and food
- Record the type and amount of fluid you drank and food you ate. Record when you woke up for the day and the hour you went to sleep.
- Column 3: Amount voided (urinated)
- Record the time and amount each time you urinate. Mark a bowel movement with BM at the right time. There are three ways to record the amount, and you should use the first unless your provider directs otherwise.
- Column 4: Amount of leakage
- Record the amount of urine loss at the time it occurred.
- Column 5: Was urge present?
- Describe the urge sensation you had, using the 1, 2, 3 scale below.
- Column 6: Activity with leakage
- Describe what you were doing when the leakage happened, for example coughed, heard running water, sneezed, bent over, lifted something, or had a strong urge.
- Comments
- At the bottom of the log, note special problems and any new or changed medication. If you needed to change a pad, record the number used during the day.
Ways to record the amount voided
- Small, medium, largePut an S, M, or L in the box for the time each time you urinate. S (small) seemed like a small amount, or you went “just in case.” M (medium) seemed like it would have run over an 8-ounce measuring cup. L (large) seemed like the amount you urinate when you first wake up.
- Count secondsIf you have trouble judging the amount, count “one one-thousand” (about one second) while emptying your bladder, and record the total seconds.
- Measure itUse a collection device, ideally a collection “hat” that sits over the toilet. Ask your provider where to get one. Measuring cups of 2 to 4 cups can work, but urine is harder to catch. Record the ounces.
- Leakage amounts
- S (small): a drop or two of urine. M (medium): wet underwear. L (large): wet outerwear or floor.
- Urge scale
- 1 mild: first sensation of the need to go. 2 moderate: a stronger sensation. 3 strong: you need to get to the toilet right away.
Example
| Time | Food and fluid | Voided (S/M/L) | Leakage (S/M/L) | Urge (1/2/3) | Activity with leakage |
|---|---|---|---|---|---|
| Midnight to 5 am | |||||
| 6 am | Woke up at 6:45 am | L | 3 | ||
| 7 am | Coffee, bagel | ||||
| 8 am | M | Fast walking | |||
| 9 am | Apple | M | 2 | ||
| 11 am | S | 1 | Key in the door | ||
| Noon | Tuna sandwich, milk, pear | ||||
| 2 pm | M | 2 | |||
| 3 pm | Tea, cookies | S | Running water | ||
| 6 pm | Chicken, corn pudding, salad, apple juice | M | 3 | ||
| 8 pm | S | 3 | |||
| 10 pm | To bed at 10:30 | M | 3 |
Comments: week before period.
Daily voiding diary
Name: ______________________ Date: ______________
| Time of day | Food and fluid intake | Amount voided (S/M/L) | Amount of leakage (S/M/L) | Was urge present? | Activity with leakage | Bowel movement |
|---|---|---|---|---|---|---|
| 12:00 a.m. | ||||||
| 1:00 | ||||||
| 2:00 | ||||||
| 3:00 | ||||||
| 4:00 | ||||||
| 5:00 | ||||||
| 6:00 | ||||||
| 7:00 | ||||||
| 8:00 | ||||||
| 9:00 | ||||||
| 10:00 | ||||||
| 11:00 | ||||||
| 12:00 p.m. | ||||||
| 1:00 | ||||||
| 2:00 | ||||||
| 3:00 | ||||||
| 4:00 | ||||||
| 5:00 | ||||||
| 6:00 | ||||||
| 7:00 | ||||||
| 8:00 | ||||||
| 9:00 | ||||||
| 10:00 | ||||||
| 11:00 |
Comments: ____________________________ Number of pads used: ______
This handout is for education and does not replace advice from your own healthcare provider.