Urology & Urogynecology > Education and Reference

It falls within the practice scope of the Urodynamic Practitioner to provide the following written materials to a patient that has been scheduled for urodynamic testing:

1. A Facility Specific Brochure outlining

• The basic testing to be performed
• Instructions for the day of the test

2. A History Questionnaire to be completed prior to arrival
3. A Bladder Diary, Voiding Diary or Intake/Voiding Diary to be recorded for a minimum of 24 hours prior to arrival

A patient that has been prepared with a FACILITY SPECIFIC BROCHURE containing instructions and a brief description of the procedure to be performed will typically arrive more relaxed and be more cooperative.
The brochure should include:

1. Directions to the facility and lab
2. What to wear the day of the test
3. Brief descriptions of the types of tests performed in the lab
4. Name and phone number of the person to contact for questions, etc.

The HISTORY QUESTIONNAIREis an extremely valuable tool for the urodynamicist. Its value includes insight into:

1. The patient’s understanding of their daily bladder and bowel habits
2. Medications the patient may be taking that affect their bowel and bladder status (prescription and over-the-counter)
3. Existing medical conditions that can affect bladder/bowel status (back injuries, neuromuscular diseases, diabetes, vascular disease, etc)

According to the ICS, the bladder diary… “provides objective verification of the patient’s symptoms, and furthermore, key values for plausibility control of subsequent urodynamic studies, for example, in order to prevent over-filling of the patient’s bladder.”(1)

The ICS describes three different types of bladder diaries.
VOIDING DIARY
BLADDER DIARY
   ~ or ~
INTAKE/BLADDER DIARY

• Output volumes
• Output patterns

A Bladder Diary is used to document the time and volume of each void in a 24-hour period plus symptoms and events, providing information on:

Output volumes
Output patterns
Functional bladder capacity
The nature and timing of urgency, pain, incontinence episodes and pad usage

An Intake / Bladder Diary is used to document the time, volume and type of intake and the time and volume of each void plus symptoms and events during a 24-hour period, providing information on :

Intake patterns
Consumption of bladder irritants
Output patterns
Functional bladder capacity
The nature and timing of urgency, pain, incontinence episodes and pad usage

There are varying opinions in the literature and urodynamic community about how many 24-hour periods are most helpful, but the general consensus is that a 2-day diary is best. It is a common practice to utilize a Voiding Diary or Bladder Diary and then, if the documentation shows excessively large or small volumes, or unusual time patterns, the patient is instructed to complete sequential Intake/Bladder Diaries. These are practice based decisions. However, most practitioners that have incorporated bladder diaries into their routine find them invaluable.