Keeping a bladder diary helps us to make an assessment of how your child’s bladder is working and helps identify the best treatment.
Please record the following and bring this form with you to your clinic appointment:
• Number of drinks your child had during the day and approx. total volume of drinks.
• Type and time of drink your child had before sleep.
• Whether your child is dry or not at parent’s bed time.
• Whether your child woke in the night to use the toilet.
• Whether your child achieved a completely dry night.
• If wet, the size of the wet patch (small= coin size patch, medium = dinner plate size and large = wet from head to toe).
• Number of times your child went to the toilet for a wee during the day.
• On at least 3 days please measure one wee (not the 1st wee in the morning) in a plastic jug and record in the last column.
Bed Wetting Assessment Chart
| Date | Number of Drinks / Volume | Last Drink | Parent Check wet/dry | Woke self to Toilet Y/N | Dry Night | Size of Wet Patch | Number of times to Toilet in Day | Bowels Open? Y/N | Measurement of Urine in Mls |
|
Example 21/01/2021
|
4 drinks 800mls /day | 18:00 cup milk | dry | N | N | Large | 6 | Y | 230mls |
If you have any questions or concerns about completing this chart, or if you would like any further information, please contact:
Paediatric Continence Service
Whitegate Health Centre
150-158 Whitegate Drive
Blackpool, FY3 9ES
Telephone: 01253 953042
Eric the Children's Bowel and Bladder Charity
http://www.eric.org.uk
Bladder & Bowel UK
http://www.bbuk.org.uk/
The Patient Relations Department offer impartial advice and deal with any concerns or complaints the Trust receives.
You can contact them via telephone number: 01253 955589 or by email: bfwh.patientrelations@nhs.net
You can also write to us at:
Patient Relations Department,
Blackpool Teaching Hospitals
NHS Foundation Trust,
Blackpool Victoria Hospital,
Whinney Heys Road,
Blackpool FY3 8NR
Further information is available on our website: www.blackpoolteachinghospitals.nhs.uk
If you’d like a large print, audio, Braille or a translated version of this booklet then please call: 01253 955520
Author Rebecca Adair
Reference No PL/980 (V3)
Review date 01/07/2027
