What is a clinician to do-believe the patient or her urinary diary?

Purpose: We determined if patient recall of incontinence episodes correlates with urinary diary record. Materials and Methods: Women with 1 or more urge incontinence episode per week completed 2, 7-day diaries, the Urinary Distress Inventory and Incontinence Impact Questionnaire, and responded to 2 recall questions. Results: The median number of incontinence episodes participants recalled (6.5, 5) was higher than those recorded in the diary (1.9, 1.1) at both points. Incontinence episodes in 2, 7-day diaries correlated strongly (p = 0.921, p < 0.005) while participant recall of incontinence episodes correlated weakly (p = 0.309, p < 0.059). When subjects reported being only slightly or not bothered by urge incontinence, recall and diary record correlated strongly (p = 0.812, p = 0.014). With increasing bother (moderate or great), recall and diary were not significantly correlated (p = 0.528, p = 0.115). Conclusions: Women with urge incontinence either overestimate or under record incontinence episode frequency in the urinary diary. This effect is more pronounced in women who are more bothered by incontinence.