The voiding diary below is one of the most important tools to help you and your physician better identify your condition and choose the best possible treatment for you. Please complete it as accurately as possible for three days (Day = sun & Night = moon)
Click here to download your very own Voiding Diary
How to complete:
- Begin recording upon rising in the morning and continue for a full 24 hours.
- List all fluid and food intake.
- list each time you go to the bathroom to urinate and record the amount of urine in ounces (any container can be used to measure output – but be consistent each time). If unable to measure, list as small medium or large amount.
- In the “leakage amount” column, write a 1, 2 or 3 to record the volume of leakage
- If you changed a pad or any protective garments, mark that column with an “X”.
- In the “Activity” column, write down what you were doing when the leakage occurred. For example: coughing, sneezing, laughing, walking, sleeping, ect.