Incontinence/Bladder Chart

mtcaregroup1 monica43472 albert82870 282 Users are discussing this topic

This form is to: 1) Record the times you pass urine, 2) Record the amount of urine you pass on each occasion and 3) Record the times you leak urine (are incontinent).

  • Tick (to the nearest hour) each time you go to the toilet to pass urine.
  • If your doctor or nurse asks, when possible, also record the amount (volume) of urine you pass each time. You can use a household measuring jug to do this. If you are away from home and it is inconvenient to measure the amount then just record the time with a tick.
  • If you leak urine unintentionally, record the times it happens (to the nearest hour). Put one, two or three + signs in the box. + = damp. ++ = wet. +++ = soaking.
214.gif
Original Author:
Dr Tim Kenny
Current Version:
Peer Reviewer:
Dr Hayley Willacy
Document ID:
4770 (v39)
Last Checked:
29/04/2014
Next Review:
28/04/2017
The Information Standard - certified member
Now read about Urinary Incontinence

Did you find this health information useful?

Yes No

Thank you for your feedback!

Subcribe to the Patient newsletter for healthcare and news updates.

We would love to hear your feedback!

 
 
Patient Access app - find out more Patient facebook page - Like our page