Three-day bladder diaries and volume charts constitute a valuable diagnostic tool in evaluating patients with lower urinary tract symptoms (LUTS) by providing relatively objective information on voiding habits and fluid intake. However, it requires a significant effort for patients to complete, especially concerning the duration and the urine collection for the void volume measurements.

The aim of this study is to design a simpler version of the voiding diaries and assess the cognitive validation in healthy volunteers to give information about voiding parameters in comparison with a three-day bladder diary/volume chart.

We designed a simple voiding record including the following items, which must be filled for every urination during 24-hours: day/night, scarce/abundant, voiding difficulty yes/no, urgency yes/no, incontinence yes/no, number of pads. Instructions to be completed are briefly included. Healthy volunteers, of at least 18 years of age, were recruited to complete a version of bladder diary/volume chart and the new voiding record, for 2 consecutive days each one. 

The following measures were derived from both registers (averages per 24-hour period): number of total voids, number of day voids, number of night voids and number of incontinence episodes. Urgency was measured by comparing “urgency yes” in the voiding record with “urgency grade 3-4” in the bladder diary. Total voided volumes were recorded in the volume charts and compared with “scarce/abundant” item of the voiding record by setting a cut-off point at ≤150 mL and ≥400 mL, respectively.

Data were presented mainly as frequencies, expressed as a percentage in categorical variables. In quantitative variables, data were presented as mean and standard deviation [mean (SD)]; the range was also reported. The student's T-test for continuous variables was used for analyzing the differences for quantitative variables among the two versions of the bladder diary. Different cut-off points of micturition per day were evaluated to assess differences between mean urine volume. The p <0.05 were considered statistically significant.

A total of 20 healthy volunteers completed both versions for a total duration of two days each. Among the participants, 10 were women and 10 men, with a mean age of 42.5 (14.5) years old (range 27-69). 

The mean number of total voids, day voids and night voids per 24‐hour period were comparable between the two versions with no significant differences: 9.40 vs 9.15 (p=0.92), 8.5 vs 8.23 (p=0.84) and 0.93 vs 0.90 (p=0.92) respectively. There were no incontinence episodes recorded. Urgency “yes” in the voiding record was compared with urgency grade 3-4 in the voiding diary, with no significant differences found (mean 0.53 vs 0.4; p=0.14).

Mean voided volume was 192.42 (41.01) mL among the participants (range 120-286). No differences were found between both records concerning the number of ≤150 mL voids in the volume chart and “scarce” voids in the voiding record: 3.88 (2.3) vs 2.6 (1.9), (p=0.80). However, differences were statistically significant when comparing the number of ≥400 ml voids with “abundant” voids: 0.35 (0.53) vs 5.45 (2.6), (p<0.001).

We analyzed the mean voided volumes in patients with a mean number of day voids ≥10 (184.9 ± 36 mL), compared to those with <10-day voids (195.4 ± 43 mL), without significant differences among both groups (p 0.298). However, patients with ≥10-day voids reported scarce or ≤150 mL voids more frequently [5.55 (2.6)] than the group with <10-day voids [3.2 (1.8)], being these differences statistically significant (p 0.003).

A simpler voiding record, without the measurement of the void volumes, may allow the determination of day-time and night-time voiding frequencies, urgency and incontinence episodes. In addition, it allows the assessment of voiding difficulty. Regarding voiding volumes, despite avoiding urine collection, an adequate correlation was observed for voids considered scarce (<150 mL). However, further studies are required to detect a more accurate threshold for estimating volumes considered abundant. Moreover, the analysis of patients with higher day-time voiding frequencies (≥10) showed a significant reduced void volume (scarce or < 150 mL) compared with those with <10-day voids (p 0.003).

The design of a new voiding record of easier completion may be more practical, increase the compliance rates and be helpful in the evaluation of patients with LUTS, as an alternative to bladder diary and volume charts in general urology and primary care attention. Preliminary results show adequate correlation with bladder diary for most of the parameters. It could help obtain a better fulfillment rate to select patients who require referral to functional urology units