Urology Health Topics
| This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition. Exención de responsabilidad en Español | Complete disclaimer
Frequency and Volume Chart - Print-friendly version of this chart, click here!
This chart is a very important part of the preparation you need for your appointment with the urologist. It will help provide your urologist with information that may relate to your symptoms and will be useful in making a diagnosis and providing treatment. It is essential that you complete the chart and bring it with you to your appointment.
Please continue your normal schedule of eating/drinking and activity so we have a record of how much you normally drink (fluid intake), how much urine you make, and how often you empty your bladder on a daily basis.
Keep the diary with you and fill it out, as completely as possible, for three days before your Urology appointment. These do not have to be three consecutive days, but should each encompass a 24-hour period of time. To measure your urine, you can purchase an inexpensive measuring cup (i.e. 2 cup). You want something that will be easy to carry with you.
- This is a record of your urine output & fluid intake.
- Choose 3 days (entire 24 hrs) to complete this chart – they DO NOT have to be 3 days in a row.
- Pick days which will be convenient for you to measure and record everything that pertains to you on the chart.
- A plastic measuring cup, small bowl or urinal can be used to measure your urine volume each time you empty your bladder.
- Record separate times for voids, catheterizations, leaks and fluid intake.
- If you use a catheter to empty your bladder, note the urine volumes obtained.
- Measure urine volumes and fluid intake volumes in either ounces or cc’s (1cc = 1ml).
- When recording a leak – please record the amount you leaked, whether you had to change your pad, your activity during the leak and your degree of urgency using the scale on the chart.
- If you experience bladder or pelvic pain – please indicate the severity of pain that you have with each event noted using the scale on the chart.
Created by J. Latini \ D. Crider 2005
Revised by J. Latini \ D. Crider \ C. Neer \ D. Allore 2006