Bladder diary Analysis Pelvic Physical Therapy Distance Journal Club March 13, 2013

Beth Shelly, PT, DPT, WCS, BCB PMD

Amundsen CL, Parsons M, Tissot B, Cardozo L, Diokno A, Coats A. Bladder diary measurement in asymptomatic females: functional bladder capacity, frequency, and 24-hr volume. Neurourol and Urodynam 2007 26:341-349

 

Tissot W, Amundsen CL, Diokno AC, Webster GD, Coats A. Bladder diary measurements in asymptomatic males: frequency, volume per void, and 24 hour volume.  Neurourol and Urodynam 2008 27:198-204.

 

Abbrev.	Name / description	Formula
V24	Total 24 hour urine volume	Add all volumes voided in 24 hrs starting with the second void of the day and including the first void of the following day
F24	Total 24 hour frequency	Count number of voids in 24 hrs starting with the first morning void
Vave	Average volume per void	V24/F24
Vmax	Maximum single volume per void	List single largest volume voided

 

Amundsen 2007 - Female

Subjects : 161 asymptomatic females

Table 3 (top of page 344) - range and mean of typical bladder dairy measurements

 

Tissot 2008 - Male

Subjects : 92 asymptomatic males

Table 1 top of page 199 - range and mean of typical bladder dairy measurements

 

V max or functional bladder capacity

·         decreases with age (smaller bladder capacity as we age)

·         increases with increased V24 (or increased fluid intake)

F24

·         increases with age (smaller bladder capacity)

·         increases with increased V24

 

Bladder dairy values should be adjusted by age, gender, and V24

 

 Patient example #one          Age: 60  Male       

 

Day bladder pattern

	Patient’s value	Norms	Interpretation
V24	2625	1750
F24	11	7-7.5
Vave = V24/F24		255-325
Vmax	350	650

 

 

Parsons M, Tissot W, Cardozo L, Diokno A, Amundsen CL, Coats A. Normative bladder diary measurements: night versus day.  Neurourol and Urodynam 2007 26:465-473.

 

Abbrev.	Name / description	Formula
Vn	Nocturnal urine volume	Add up all voided volumes included in Fn and the first void on getting out of bed for the day
Fn	Frequency of night time voids	Count number of voids from after the patient retires for the night to before the patient leaves the bed for the day includes only voids preceded and followed by sleep
NPi	Nocturnal polyuria index	Vn/V24 x 100
	# of minutes sleeping	Count total number of minutes from getting into bed for the night to getting out of bed for the day
Pn	Night urine production rate	Vn/minutes from retiring for the night to leaving bed for the day
P24	24 hour urine production rate	V24/1440
Pn/P24	Night / 24 hr production rate ratio	Pn/P24 x 100

 

 

Night time urine production increases with age

Bladder capacity decreases with age

                                      increased Fn

 

Night time urine production increases with age

·         20 yo female - 1.4 ml/min

·         70 yo female - 2.1 ml/min (50% increase)

Table 5 page 471 - night time bladder measurements by age

 

Nocturia defined as 2 of more voids per night

·         18 to 49 yo - more women

·         50 to 59 - equal male and female

·         60 and older - more men

 

Night/ 24 hr urine production rate is the best measure of nocturnal polyuria.

  

Patient example #one          Age: 60  Male

 

Night bladder pattern

	Patient’s value	Norms	Interpretation
Vn	550	446
Fn	1	0.4
NPi = Vn/V24 x 100 = %		26.6%
# of minutes sleeping	360 min	----------------------------
Pn = Vn/min asleep		0.99
P24 = V24/1440		-----------------------------
Pn/ P24 x 100 = %		84.95%