This diary is a very important part of your urologic evaluation.
It will provide information that may relate to your symptoms and will therefore be useful in making a diagnosis. Please continue with your normal daily habits, so that we may have a representation of your normal daily intake of liquids and voiding patterns.
Carry this diary and a measuring device with you for a 48-hour period.
Measure all urinary output and write the amount in the appropriate space provided below.
Place a mark in the “leakage” column if you experience leakage. Note the type of activity you were engaged in when the leakage occurred (e.g. Sneeze, cough, climbing stairs, sleeping) and quantify the amount of leakage (e.g. few drops, soaked pad).
Write the amount and type of fluid intake and the appropriate column. Try to be as accurate as possible. Example: 8 ounce cup of milk, 12 ounce beer, 6 ounce coffee, etc.