Digital versus paper-based voiding diaries: a feasibility study of usability, data quality, patient satisfaction and adherence

PURPOSE: This study aims to compare the effectiveness, user experience, usability, and clinical utility of an electronic voiding diary (EVD) versus a traditional paper-based voiding diary (PVD) in patients undergoing robot-assisted radical prostatectomy (RARP). METHODS: In this exploratory feasibility study, 29 patients completed both an EVD and PVD following catheter removal, documenting micturition, pad use, and fluid intake. Usability was assessed using the System Usability Scale (SUS), task performance, and questionnaires on digital habits. Data were stratified by age, screen time, and app usage. RESULTS: This study included 29 men (mean age 65.24 ± 6.73 years) after RARP. SUS scores were higher in patients with regular app use (79.85 vs. 43.33; p = 0.024). In patients with ≥ 2 h daily screen time SUS Scores were 80.42 vs. 59.32 (< 2 h daily screen time; p = 0.139). Regular app users consistently preferred the EVD across all four evaluated categories: usability (regular app use 1.19 EVD vs. infrequent app use 2.17 PVD; p = 0.014), misunderstandings (0.25 PVD vs. 1.83 EVD; p = 0.049), learnability (1.00 EVD vs. 2.33 PVD; p = 0.030), and graphical presentation (3.38 EVD vs. 0.33 EVD; p = 0.020). CONCLUSION: This feasibility study demonstrates that EVDs are practical, reliable, and well-accepted for early postoperative monitoring after RARP. Usability was strongly influenced by age and digital experience, with younger, regular app users with higher daily screen time performing better. These findings support further development and broader implementation of EVDs in urological care.