Voiding Diaries and the Patients History

The voiding diary represents a self-monitoring daily record of the patient's voiding behavior, whereas the history is a verbal explanation of the patient's complaint. It can be difficult for the patient to recall or judge their voiding frequency and pattern retrospectively, especially when their voiding behavior is irregular.8 Patients are sometimes surprised at the actual number of voiding events that occur once they are asked to record them. The diary also provides an evaluation of treatment,which is more accurate than the history, because patients sometimes claim improvement, presumably to please their doctors,when their diaries show no change. However, the diary is only supplemental to the patient's history, and both should be used to identify the complaint and formulate an accurate diagnosis.

Several attempts have been made to use an analysis of the patient's history to help predict the type of incontinence; most have revealed that patient history is a poor predictor of the underlying cause of incontinence.9,10 Sand et al.11 reported that the history has a good sensitivity for genuine stress urinary incontinence but not for urge. McCormack et al.12 revealed poor agreement between subjectively estimated urinary frequency and urinary frequency shown on a chart.

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