Bladder Diary
There is such a stigma attached to loss of bladder control and the shame of it is that there is almost always something that can be done.
The urine bladder diary gives your doctor a picture of your incontinence. Keeping an accurate and thorough diary will allow your doctor to see a clearer picture of your individual situation. Try to keep your diary for at least a week before you see your doctor, then take it with you to your appointment.
Click here to download your Bladder Diary.
Instructions for Bladder Diary:
- Make at least seven copies of the blank bladder diary form so that you can keep the diary for a week.
- Record the time of day when you void in the toilet or have leakage.
- Record (yes/no) that you voided in the toilet in the “Toilet” column.
- Indicate the degree of leakage (none/damp/wet) in the “Leakage” column.
- Indicate if you changed your absorbent product or had to change your clothing.
- Note your activity at the time of any leakage.
- Measuring the amount you drank or voided may help the doctor or nurse assess your condition. If possible, record these measurements in the “Fluid Intake” and “Fluid Output” columns.




