Month: May 2021

Printable Bowel Movement Chart – Poo diary

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Bowel movement and voiding Diary is a tool that allows to record how much liquid you drink, how often you go to the restroom. And some additional information like when you experience urine leakage and urgency. Bowel movement and voiding diary is also known as Bladder Diary, Bristol chart, poo log, stool diary or Frequency volume chart (FVC).

How to complete – Instructions for Completing a 3-Day Bowel movement chart

1. Complete the bowel movement and bladder diary for a total of 3 days. 24×3

2. On the day that you start recording events in the bowel movment and bladder diary. Print your name and full date at the top of the diary.

How to record in the diary:

Hour: Use one bowel and voiding diary sheet for each 24-hour period. Circle your bedtime (example, 11pm) and wake-up time (example 7am) directly in the time column. Start recording all fluid intake, bowel movement and urinary events starting at 7am and ending the following day at 7am. Write down the event next to the appropriate hour time slot when it occurred.

Fluid: Under “fluid intake”, write the total amount of fluids you drank. This could be in ounces or ml– during a given time period.

Toilet : In the column marked “toilet voids and bowel movement”, remember to make sure that the urinary container is in the toilet. On each time you urinate. Record the amount of urine you voided (in ml) each time you urinated in the toilet over a 24-hour period.

Bristol chart

Use a Bristol chart to rate the bowel movement shape.

  • Type 1-2 indicate constipation,
  • 3-4 are ideal stools as they are easier to pass, and
  • Type 5-7 may indicate diarrhea and urgency. 

Tired of the manual way of recording pee? Consider getting an iUFlow device. Provide your PT or Urologists with real-time bladder data.

Leaks: Under “leaks”. Mark each time you had involuntary urine loss (even a small amount) before you made it to the toilet.

Urge: Under “urge”. Rate each time you had a trip to toilet.

Start a new page for each day you keep the diary. You need to keep a diary for 3 full days, though they do not need to be consecutive days.

Clinic: __________________________

Full Name: ______________________________

Date | TimeUrine volume / Toilet tripsDrinks volumeLeakageUrgeDescription
Date and Time am/pmThe exact amount of pee in mL / Bristol chart rating 💩 (1-7)The exact amount of intake in mL / ozDid you experience any accidental leakage?
Rank it 0-4		How strong was the urge to go? Rank it 0-4 
      
      
      
      

Diagnosis Methods

Download and print your own bowel and bladder diary PDF form using this link

bowel and voiding_diary_instructions_how_to-1 — Download

Get Form ^

This is the good old way. But, you don’t feel like carrying this paper voiding diary with you? Check out a digital voiding app. iUFlow – Bladder diary. A FREE toilet tracker app available on both Android and iOS app stores.

Install it on your smartphone

How to have a Better Bowel Movement?

How to avoid constipation?

It’s easy: Drink water. Eat food that is rich in fiber. For example: fruits, lentils, nuts, grains, and vegetables. Move more.

Track every toilet trip and share the results with your doctor. With the iUFlow app it’s a 2 clicks procedure.

Shared with doctor

Feel free to contact us with any question.

iUFlow Overview

Urology 1:1 Tips and Useful information for better quality

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What is the urinary system?

How is the urinary system controlled?

Essential Tips and Info about urinary system. The urinary system, or the renal system, consist of four parts — the kidneys, the ureter, the bladder, and the urethra. The urinary system have important functions, get rid of waste, working with other organs, so the body keeps a proper chemical and water equipoise, and adjusting blood volume and blood pressure.

The bladder stores the urine until it is convenient to pee or in other words, to expel it from the body. While urine is taken from the kidney to the bladder by the ureters.

Ureter ≠ urethra

‘Ureter’ differs from ‘urethra’. While, the ureters are tubes that carry urine from the kidneys to the bladder. The urethra is the tube that transports urine out of the body.

Urine equals water, urea and salts.

Lower Urinary Tract Symptoms. Or in short, LUTS.

What are LUTS?

In other words, the lower urinary tract: bladder, prostate and urethra. LUTS are grouped, in general, into symptoms to do with storing or passing urine, like blockage. It can be symptoms linked mainly to one or the other, or a combination of both.

How common is LUTS? When you get older, LUTS are more common. In other words, with age. It can happen when you’re young, but the reason of the problem is likely to be different.

Nearly 33% of men, over the age of 70, are suffering from moderate to severe LUTS.

You’re less likely to suffer from LUTS if you have a healthy lifestyle and body weight and if you’re a non-smoker.


Urologic Conditions

Procedures

  • Uroflowmetry (at home)
  • Urinalysis
  • Bladder Scan
  • Cystoscopy
  • Testicular Self-Examination
  • Urologic Radiology

Understanding Urology

How do doctors check for bladder problems?

Your doctor will ask for your situation and will perform a physical exam. What if I completed a bladder diary and I performed iUFlow urine flow rate test already? If your doctor has ordered the test, and you have any questions or concerns, contact your doctor’s office.

Visiting a Urologist

What should I ask my doctor?

Questions to ask your doctor

  • What are results from the urine flow test telling you?
  • Does my Qmax match the volume?
  • What other test will I need to explain my problem?
  • Am I suffering from LUTS? Can LUTS be prevented?
  • Men: are the symptoms related to my prostate (such as BPH)?
  • Should I fill out a Bladder Diary?
  • What are the next-steps?

Article: Does a home bladder monitoring device improve data?

Article: Do patients feel at home? Bladder holter device

Uroflow test (conventional) – Location

Depending on the availability in your region, This test is typically performed in a hospital or a physician’s office.

How long does a uroflow take? Time.

The procedure usually takes about half an hour. Your physician might ask you to repeat the process in case the results are not valid. In other words, to fill your bladder, wait a while and measure again.

iUFlow Uroflow Urine test

Provide your doctor with real-time data.

What is an iUFlow test?

Read what is iUFlow and why you should probably consider getting one.

Voiding Diary – How to complete

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Voiding Diary is an assessment tool that allows to record how much liquid you drink, how often you urinate. And when you experience urine leakage. Voiding diary is also known as Bladder Diary or Frequency volume chart (FVC).

Instructions for Completing a 3-Day Voiding Diary

1. Complete the voiding diary for a total of 3 days. 24×3

2. On the day that you start recording events in the voiding diary. Print your name and date at the top of the diary.

How to record in the diary:

Time of day: Use one voiding diary sheet for each 24-hour period. Circle your bedtime (example, 10pm) and wake-up time (example 5am) directly in the time column. Start recording all fluid intake and urinary events starting at 6am and ending the following day at 6am. Write down the even next to the appropriate hour time slot when it occurred.

Fluid Intake: In the column marked “fluid intake”, write the total amount of fluids you drank. This could be in ml or in ounces – during a given time period.

Toilet Urination: In the column marked “toilet voids”, remember to make sure that the urinary container is in the toilet. On each time you urinate. Record the amount of urine you voided (in ml) each time you urinated in the toilet over a 24-hour period.

Tired of the manual way of doing that? Consider getting an iUFlow device. Provide your PT or Urologists with real-time bladder data.

Amount of Urine Drained via Catheter (optional). Record the amount of urine (in ounces or milliliters) that you drained using a catheter. Remark if this was a residual urine volume (example, 120 ml residual [R], or 170 ml catheter [C] void). If you do not use a catheter, leave this column blank.

Leaks: In the column marked “leaks”. Mark each time you had involuntary urine loss (even a small amount) before you made it to the toilet.

(optional) Pad Changes: In the column marked “description”, write down on each time you changed your pad. If the pad was dry, write a “D”. If the pad was wet with urine, write down whether it was a small, moderate, or a large amount.

Start a new page for each day you keep the diary. You need to keep a diary for 3 full days, though they do not need to be consecutive days.

Clinic: __________________________

Name: ______________________________

Date | TimeUrine volumeDrinks volumeLeakageUrgeDescription
Date and Time am/pmThe exact amount of pee in mLThe exact amount of intake in mL / ozDid you experience any accidental leakage?
Rank it 0-4		How strong was the urge to go? Rank it 0-4 
      
      
      
      

Diagnosis Methods

Download and print your own bladder diary PDF form using this link

voiding_diary_instructions_how_to-1Download

How to fill out a bladder diary? Here is a helpful tool to track your bladder behavior and is used to determine on how to handle incontinence or other bladder difficulties. Complete a 72-hour BD before your PT, gynecologist or urologist appointment.

This bladder diary form is printable and free to use.

But wait it’s 2022, you don’t feel like carrying this paper voiding diary with you? Check out a digital voiding app. iUFlow – Bladder diary. A FREE pee tracker app available on both Android and iOS app stores.

iUFlow starter guide

Get the iUFlow Bladder Diary app

iUFlow Dashboard – How to use?

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iUFlow Dashboard and Portal.

Firstly, log in diary.iuflow.com (click here or look for the iUFlow Portal link in menu). There you will find your current bladder diary synced from your iUFlow bladder diary app. That is to say, all your home flow rate test that you synced and your manually added events.

Secondly, access the measurements on the iUFlow user dashboard.

Understand the data of the iUFlow Dashboard and Portal

Q: I completed a bladder diary using the iUFlow app, but what is the iUFlow device?
A: iUFlow is a uroflowmeter for home use. iUFlow objectively measure volume, Qmax flow rates and frequency of a patient’s voiding activities during a prescribed interval. The easiest urine Uroflowmetry test at home. Every urination is uroflow.

iUFlow flow rate chart

If you use iUFlow home uroflowmeter: compare your uroflows and assess the effect of treatment. In other words, learn whether the medication, therapy, kegel, surgery make a difference to your flow rate.

Look for a change in flow curve shape and changes in Qmax at a specific volume.

Flow rate test example

For instance, how your flow rate looks?

Is your urine flow bell shaped? Plateau (flat)? Or sporadic?

Even in a very general look, the urination chart shape can teach us a lot. A plateau chart, or low Qmax value are commonly a sign of obstruction. It is a common symptom of BPH. In men – Benign prostatic hypertrophy. Enlargement of the prostate gland, or block of the urethra. Also, it can point to another abnormality related to the Lower Urinary Tract.
How to read Uroflow results?

Thirdly, save the current and previous reports and share them with your doctor or physical therapist. Alternatively, your clinician can log in to the iUFlow clinic portal and track your progress in real-time.

iUFlow clinician dahsboard
iUFlow Clinician Dashboard

As always, you are very welcome to contact us for more information regarding iUFlow. Or, if you have any question about interpretation of uroflow results.

iUFlow Overview

Voiding Diary Analysis – Top tips and Guidelines

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FVC analysis – continence assessment

Voiding Diary Analysis: As we all know, a 72-hour frequency volume chart (FVC) is a basic source and an important part of a continence assessment. FVC insights:

Bladder diary form to analyze

Bladder diary example

In order to get an objective picture, a three-day voiding diary is an important part of a continence diagnosis. From both the patient and doctor sides, the best is to complete one prior to the assessment. Like that, the doctor can examine the information in conjunction with the rest of the visit. What should I record in order to get a voiding diary analysis? Should I bring anything else to the meeting?

OK. What should I record?

  • On each day: the time you wake up. Similarly, the time you go to bed.
  • Measure each void. Write it down in ml or oz, recorded on the chart to the nearest hour
  • Mention the degree of urgency for each void (0 – 3: while, 0 = no urgency, 3 = very urgent)
  • Record of all wet events and degree of wetness. For example: dry, damp/dribble, wet/stream, soaked/flood or by pad weighing.
  • What you were doing when you leak
  • Record of pad/underwear alterations

Drinks and voiding

To clarify, what information needed for the fluid intake part of the form?

  • Volume of drink (how much the drinking glass holds ml)
  • Type of beverage
  • Time

Yes, leakage and Urgency scores are important. When the diagnosis is for overactive bladder, repeated voiding diary tell us a lot about the bladder behavior. Certainly, when compared.

Pad weighing, optional?

24 hour pad weighing. It is usually undertaken in care homes or in patient’s home. Pad weighing is optional and can be undertaken as part of the diary. While, 1g weight is equivalent to 1ml urine. Pad weighs are done using a 24-hour pad collection. Where all pads used in a 24-hour period are collected and weighed. Urine volume (in ml) = weight of wet pad (in grams) – weight of dry pad (in grams) Similarly.

In conclusion, what to do:

To sum up, print the bladder diary. Or download the iUFlow app, or any other Bladder diary app. Fill out:

  • Total drink volume
  • Total voiding volume
  • Frequency of urination
  • Likewise, Frequency of night (nocturia) episodes
  • Calculate: average daily urination volume
  • Likewise, calculate: Average daily urgency score

Feel free to contact if you have any questions we can assist with

Based on : Gilbert R. Fluid intake and bladder and bowel function. Nursing Times.

Many suffer from incontinence but not aware of the solutions for it. Treating incontinence starts with fully understand the nature of the problem. In other words, reliable diagnosis. Learn more on tracking your bladder habits with iUFlow voiding diary app.

Also, consider home Urine flow test for more diagnostic insights.

A modern bladder diary app can help to monitor BPH, obstruction or other prostate related symptoms.

Is Uroflowmetry on the Clinical guidelines? What CPT code?

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Is Uroflowmetry on the clinical guidelines (also referred by uroflow or urine flow test)?

Clinical guidelines and CPT code for Uroflow test. Urine flow test is an assessment of the urinary tract functionality. It is the main diagnostic tool for Lower Urinary tract symptoms (LUTS).

Urine Flow Test appears on the following clinical guidelines: Adult Urodynamics: AUA/SUFU Guideline (2012)

“Uroflow may be used by clinicians in the initial and ongoing evaluation of male patients with LUTS when an abnormality of voiding/emptying is suggested.
Lower urinary tract symptoms (LUTS), which include urinary incontinence, frequency of urination, urge to urinate and getting up at night (nocturia)
are a common and significant source of impaired quality of life and comorbidity in large numbers of adults and children.
Uroflowmetry is the measurement of the rate of urine flow over time.

Patients with various constellations of LUTS may undergo PVR or uroflow testing as non-invasive methods to screen for disorders of bladder emptying
When utilizing uroflowmetry as a screening assessment of emptying, the volume voided is vitally important. Voided volumes of at least 150 ml have been reported to be necessary for the “accuracy” of the study.”

Uroflowmetry test is shown also in the following clinical guidelines: Benign Prostatic Hyperplasia: Surgical Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms (2018, amended 2019, 2020):

Clinicians should consider uroflowmetry prior to surgical intervention for LUTS attributed to
BPH.

Conventional in-clinic Uroflow
In-clinic “old school” flow rate test

Uroflow, or Uroflowmetry is a test to measure the flow (rate) of micturition. During the test, the uroflow device, a Uroflowmeter, tracks urine flow in mL/sec. It reports Urination volume, meaning, how much urine flows out. It is that simple. Urination Time in seconds, means, How long it takes to urinate.

Uroflow CPT Code

The Urine flow test – CPT Code is: 51741
The test can be performed by an assistant or nurse.
Source

An example of per patient calculation according to Laborie. If Doctor performs also Complex CMG with Voiding Pressure Study, and EMG, and Voiding Pressure Test. For instance:

PROCEDURE2019 CPT CODEREIMBURSEMENT CALCULATION
Complex CMG with Voiding Pressure Study51728$327.60 @ 100%
Uroflow51741-51$16.15 @ 50%
EMG51784-51$71.28 @ 50%
Voiding Pressure Test51797*$116.64 @ 100%

iUFlow Home Uroflow vs. in clinic Uroflowmeter

As you already know, this is normally a bother. iUFlow Uroflowmeter is the solution to get more accurate data about your bladder behavior.

iUFlow is a wireless and disposable Uroflowmeter

iUFlow is a Uroflowmeter for home use. iUFlow uses built-in sensors to objectively measure volume, multi flow rates and frequency of a patient’s voiding activities during a prescribed interval. An easy urine Uroflowmetry test at home.

iUFlow uroflowmeter at home illustration

Yes, iUFlow was designed to make your patients’ life easier. iUFlow was built especially for patients who suffer from BPH, Overactive bladder, Nocturia, Pelvic floor related issues, or other LUTS.

How to Report Home Uroflow? What is the CPT code?

Can I bill for interpretation of home tests?

There was a discussion on that in the AUAnet blogs. It seems reasonable to choose CPT 51741 with modifier 26 one or two times. But, there is a risk that insurers deny reporting of a single CPT multiple times in one day. As an alternative, if you are receiving a series of tests and that takes more than 30 mins of clinician time. That is including discussing the results with the patient, then you should consider using CPT code 99091.

How to bill for remote uroflow?

To clarify, practice can not bill for both the uroflow interpretation (51741-26) and collection and interpretation (99091) on the same patient same day. Alternatively, one can have the patient bring in the results of their uroflow tests and use it as part of the “data” section for medical decision for a follow-up management visit.  

Read more on 51741 cpt code and Home Uroflow codes and billing at AUAnet.

iUFlow dashboard clinician view of results clinical guidelines
iUFlow dashboard

How a busy Sydney practice is utilizing iUFlow Uroflowmeter and dashboard.

Feel free to contact us for more information regarding iUFlow.
iUFlow Overview