Bladder diary in neuro-urology: feasibility, usefulness, and reasons for no completion

The bladder diary (BD) is recommended in the assessment of lower urinary tract symptoms (LUTS) in all patients; however completion may be challenging, particularly for people with neurological disorders. This study aimed to evaluate the BD completion rate in a population composed predominantly of individuals with neurological disorders, and to identify reasons for non-completion.

We conducted a prospective, observational, single-center study between January and April 2025. All patients scheduled for a consultation received their convocation letter with instructions to complete a BD. On the day of consultation, BDs were collected, and patients were asked about the reasons for non-completion if applicable, using a custom-made questionnaire with 19 possible explanations. Demographic and clinical data were also recorded.

A total of 408 patients were enrolled (mean age: 57.4 ± 15.1; 253 women [63%]), of whom 305 (75.3%) presented with neurogenic LUTS. The completion rate was 59.8%, with no difference between patients with and without neurological disorders (p = 0.88). Cognitive impairment was more frequent in BD non-completers (p < 0.01), whereas age, sex, employment status and level of autonomy did not differ between the two groups. Among the 154 non-completers, after excluding those unaware of the BD requirement, the main reasons for non-completion were psychological difficulties (27.1%), forgetfulness (20%), practical limitations (18.6%), and physical limitations (18.6%).

This real-life study showed the feasibility of BD in patients with neurogenic bladder dysfunction, and the variability of reasons for non-completion, with no characteristics predictive of or justifying non-completion.