Bladder Diary

Ready to get started? First you'll need to record a Bladder Diary. You can download one here. Maintaining a bladder diary is key to successful bladder training.

Bladder diary instructions:

  • Each page should represent a 24 hour period, from your first void of the day, until the first void of your next day (but not including that). For beginners, I recommend recording for 48 hours before starting bladder training. 
  • Record the time of all voids, leakage and intake of fluids.
  • Measure output in ounces or milliliters.
  • Note if you felt a strong urge (could not wait another 5 minutes) or had accidental leakage.
  • Note the time of day you went to sleep and woke up. 
  • Record the total number of times you needed to void during the day time and at night

How do you collect and measure your voids?
Collect your urine in a toilet specimen collector. Your physician may be able to give you one. You can also purchase one online for around $5. Amazon.com sells them.

 

Interpreting your bladder diary:
Now that you've recorded a diary, it's time to figure out what all this means and put your efforts to good use. Here are some things you can determine:

  • Voiding volumes -- this is the amount of fluid you measured per void. An adult bladder can normally hold 300-400ml or 10-14 oz. If the amount of urine you are producing per void is greater than 300ml/10oz, then you are consuming too much liquids. This may be related to an underlying medical condition, such as diabetes; therefore, you should see your medical provider for further evaluation. In the absence of any other medical condition, decreasing your fluid intake by 25% has been shown to significantly decrease voiding episodes (see Fluid Management). 
  • Voiding frequency -- this is how many times you go in a 24 hour period. Simply count the number of times you voided. The normal number of times one voids per day varies according to age. Most adults void up to 7 times during waking hours. 
  • Nocturia -- this is defined as the interruption of sleep one or more times with the urge to void. By noting when you went to sleep, you can identify nocturia episodes. Isolated nocturia with normal day time voiding frequencies could indicate obstructive sleep apnea or congestive heart failure and should be evaluated by a physician. 
  • Voiding interval -- this is the time from one void to another. For example, if you voided at 2PM and then at 4:30PM, your voiding interval is 2.5 hours. After calculating all the voiding intervals for the day, you will be able to identify the shortest voiding interval. This is an important value for bladder training.
  • Incontinence episodes -- when you had accidental leakage.
  • Fluid intake -- the amount of fluid you take in may be helpful to know if it seems you are drinking too much. Simply put, the more you consume the more you'll urinate. How much you need to drink depends on several factors, and it can range from 8 to 13 cups per day. Keep in mind you also get plenty of fluids from the foods you eat. See what Mayo Clinic has to say about water consumption here. Your bladder diary will also allow you to see when you are drinking. Avoiding drinking just prior to sleeping will reduce episodes of nocturia. Also, the type of drink you are consuming may play a role in your OAB symptoms. The content of some food and drinks may be irritants to your bladder. See Dietary Management for more info. 

Now let's move on to bladder training!