To compare 1-day, 3-day, and 7-day Voiding Diaries (VD) for the assessment of severe Overactive Bladder (OAB) in boys aged 7 to 12 years, and to identify the optimal VD duration that balances accuracy and feasibility in pediatric clinical practice.

A total of 180 school-aged boys with severe OAB were initially enrolled in this study, and 165 patients ultimately completed the 7-day voiding diary (7d VD), with a completion rate of 91.67%. A total of 15 cases were lost to follow-up, mainly due to non-standard recording by caregivers (10 cases) and loss of contact during follow-up (5 cases). The 165 patients who completed the study were aged 7 to 12 years, with a mean age of 9.50±1.755 years. Friedman test revealed statistically significant differences in the average voided volume, daytime voiding frequency and incidence of daytime urinary incontinence recorded by the three voiding diary groups (1d VD, 3d VD and 7d VD) (P<0.05). Further pairwise comparisons showed that there were significant differences in maximum voided volume and nocturnal voided volume between the 3d VD and 7d VD groups (P<0.017), while statistically significant differences were observed in the above three indicators between the 1d VD and 3d VD groups as well as between the 1d VD and 7d VD groups (all P<0.017). Additionally, comparison of the indicators before and after treatment assessed by 3d VD showed statistically significant differences (P<0.05).

A total of 180 school-aged boys with severe OAB were initially enrolled in this study, and 165 patients ultimately completed the 7-day voiding diary (7d VD), with a completion rate of 91.67%. A total of 15 cases were lost to follow-up, mainly due to non-standard recording by caregivers (10 cases) and loss of contact during follow-up (5 cases). The 165 patients who completed the study were aged 7 to 12 years, with a mean age of 9.50±1.755 years. Friedman test revealed statistically significant differences in the average voided volume, daytime voiding frequency and incidence of daytime urinary incontinence recorded by the three voiding diary groups (1d VD, 3d VD and 7d VD) (P<0.05). Further pairwise comparisons showed that there were significant differences in maximum voided volume and nocturnal voided volume between the 3d VD and 7d VD groups (P<0.017), while statistically significant differences were observed in the above three indicators between the 1d VD and 3d VD groups as well as between the 1d VD and 7d VD groups (all P<0.017). Additionally, comparison of the indicators before and after treatment assessed by 3d VD showed statistically significant differences (P<0.05).

3d VD and 7d VD showed highly consistent comprehensive assessment efficacy in boys with severe OAB. Despite statistical differences in maximum voided volume [3d VD:127.8(102.4,153.6)mL;7d VD:129.8(108.2,156.0)mL] and nocturnal voided volume [3d VD:62.4(45.4,73.4)mL;7d VD:67.2(54.7,81.2)mL], the numerical variations were clinically insignificant for condition evaluation in this pediatric group. Combined with clinical symptom improvement, 3d VD can effectively replace 7d VD for both baseline assessment and post-intervention dynamic monitoring of voiding parameters in severe pediatric OAB, providing valuable clinical guidance for optimizing diagnosis and treatment protocols and a reliable evidence base for pediatric urological practice.

The 3d VD is the optimal assessment duration for evaluating 7–12-year-old boys with severe wet overactive bladder (OAB), balancing diagnostic accuracy and clinical feasibility in pediatric urological practice.