Resources for the Comprehensive Geriatric Assessment based

Proactive and Personalised Primary Care of the Elderly

Interpretation

 

Interpretation of Bladder Diary data is largely subjective and should be considered in conjunction with other pertinent data.relating to possible causes of incontinence.

The mnemonics DIAPPERS and TOILETED are useful in this regard

General pointers that may be gleaned from Bladder Diary data include:

 

• Normal voided volume and frequency

 

• Increased volume day and night

Polyuria = 24 hr output > 3 litres

Managed by lifestyle intervention + decreased intake (never <1500ml/day)

 

• Increased volume at night, normal during the day

Nocturnal polyuria = > 33% of total output occurs at night

Suggestive of fluid retaining states, hormonal fluid balance abnormality or idiopathic in origin.

This is a commonly occurring bothersome symptom caused by physiological problems (i.e. renal, cardiac, CNS or endocrine)

 

• Normal volume + increased frequency day and night

Suggesting a high fluid intake.

This may be related to diabetes mellitus or diabetes insipidus, but is more usually habitual.

 

• Normal volume and daytime frequency + increased night frequency

Nocturia, suggesting storage LUTS

 

• Reduced volume with variation in the volume voided

Suggestive of underlying detrusor overactivity  as the bladder contracts at variable degrees of distension before maximum capacity, erroneously informing the patient that it is full, resulting in urinary frequency and low and variable voided volumes.

 

• Reduced volume with minimal variation in the volume voided

Suggesting bladder wall pathology such as carcinoma in situ or painful bladder syndrome/interstitial cystitis or carcinoma in situ.

This Tool is used in the assessment of

Urinary Incontinence

Back To : Urinary Incontinence

Urinary Incontinence is one of 4 conditions identified as

Geriatric Syndromes

Back To : Geriatric Syndromes