Voiding diary

This diary will help us determine why you have trouble holding your urine or why you go to the bathroom very often
Keep this record for at least two days.
Please write down four things every time you pass or leak urine:

The time (for example, "10:30 AM")
The amount of urine that you pass
Whether you leaked any urine (were "wet") or not (were "dry")
Whether anything special may have caused you to go (for instance, "just had coffee," "coughed," "was running to the bathroom," "just took my water pill")

Start the record in the morning the first time you go to the bathroom after you get up. Please write on the form the time you got up and the time you went to bed.
To measure the amount of urine you pass, we will give you a special receptacle (called a "hat"). Place the hat in the toilet to catch the urine every time you go. Look at how high the urine fills the hat, and write down the amount from the numbers on the inside of the hat. Remember to empty the hat after each time you go.
If you leak urine and cannot measure the amount that came out, write down your best guess.

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