Twenty-Four-Hour Voiding Diaries Versus 3-Day Voiding Diaries: A Clinical Comparison

Area of Science:

• Urogynecology
• Female Pelvic Medicine

Background:

• Urinary incontinence diagnosis often relies on patient-reported voiding patterns.
• Voiding diaries are crucial tools for assessing urinary incontinence.
• Standard practice typically involves a 3-day voiding diary.

Purpose of the Study:

• To compare the impact of 24-hour versus 3-day voiding diaries on medical decision-making for women with urinary incontinence.
• To evaluate if shorter diary duration influences diagnostic and treatment plans.

Main Methods:

• Retrospective chart review of 186 patients with urinary incontinence.
• Comparison of treatment plans based on initial 3-day diaries versus re-evaluation using 24-hour data.
• Physician re-evaluation blinded to previous decisions.

Main Results:

• Good agreement between 24-hour and 3-day diaries for behavioral modifications (κ > 0.6).
• Moderate agreement for medical therapy or pessary initiation (κ > 0.4).
• 24-hour diaries led to a statistically significant increase in invasive diagnostic tests (P < 0.019).

Conclusions:

• 24-hour voiding diaries may prompt increased invasive testing compared to 3-day diaries.
• Consider postponing invasive procedures until a comprehensive history, potentially from a longer diary, is obtained.
• This finding suggests optimizing diary duration for efficient and appropriate patient management.