***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The frequency of bacteriuria is high in children with neurogenic bladder on intermittent catheterization for bladder emptying . In an effort to decrease bacteriuria , we examined whether the method of catheter care was responsible for the high rate of bacteriuria . For this , the frequency of bacteriuria was examined in the same patient on single-use sterile catheters and on reused clean catheters . METHODS A prospect i ve , r and omized , crossover trial was conducted with 10 patients who were r and omized to 4 months of a new , sterile catheter for intermittent catheterization and 4 months of reuse of a clean catheter for intermittent catheterization .  Each week , a urine sample was collected and symptoms of infection and medication use were recorded . RESULTS A total of 158 urine sample s were collected during 164 patient-weeks on the new catheter method for each void ; 115 ( 73 % ) were positive for a pathogen . Of the 161 sample s collected during 169 patient-weeks on the st and ard , reuse method for voiding , 123 ( 76 % ) were positive ( 115 [ 73 % ] of 158 vs 123 [ 76 % ] of 161 ) . Escherichia coli was the most common pathogen detected during both method periods . CONCLUSION A new , sterile catheter for each void did not decrease the high frequency of bacteriuria in patients with neurogenic bladder on intermittent catheterization PURPOSE We compared a recently developed hydrophilic catheter to the st and ard polyethylene catheter in regard to hematuria , infection and patient satisfaction . MATERIAL S AND METHODS A hydrophilic LoFric or st and ard Mentor catheter was assigned at r and om to 17 and 16 boys , respectively , who were skilled in intermittent self-catheterization . They were evaluated by weekly urinalysis and a question naire . RESULTS Significantly fewer episodes of microscopic hematuria occurred in the LoFric than Mentor catheter group ( 9 episodes in 6 subjects versus 19 episodes in 11 , p < 0.05 ) . There were also fewer episodes of bacteriuria in the LoFric group but the difference was not statistically significant . Mean scores plus or minus st and ard deviation on a visual analogue scale with 0 equal to most and 10 equal to least favorable were LoFric 3.3 + /- 2.8 versus Mentor 4.9 + /- 2.7 for catheter convenience and 2.7 + /- 2.4 versus 4.2 + /- 2.6 for insertion comfort , significantly favoring the LoFric group ( p < 0.05 for both ) . Of the 16 LoFric subjects 13 preferred to continue its use , particularly those with a history of urethral trauma or sphincteric spasm . CONCLUSIONS In boys the LoFric catheter appears to cause less trauma . Although it is not reusable and is more expensive than the st and ard catheter , satisfaction is higher with the LoFric device and for select patients it has significant advantages Background This systematic review up date s a previous review published in 2000 . The objective of this review was to present the best available evidence relating to the prevention of  catheter‐associated urinary tract infections ( UTI ) . Selection criteria This review considered r and omised controlled trials ( RCTs ) of adult patients with short‐term urethral catheters . In the absence of RCTs , other research design s such as non‐r and omised controlled trials and before and after studies were considered for inclusion . Interventions of interest were those related to the prevention of catheter‐related UTI and included : sterile versus non‐sterile insertion technique , special coatings to catheters versus st and ard non‐coated catheters , the use of flush solutions , the use of solutions added to urinary drainage bag , maintenance of a closed urinary drainage circuit , the use of antireflux valves , antibiotic creams applied to the external meatus‐catheter interface , meatal care regimens , education programs , and changed care delivery practice s. This review was limited to short‐term urethral catheters , and so studies evaluating long‐term or suprapubic catheters were excluded . The primary outcome of interest was the difference in the rates of UTI between experimental intervention and the control . Search strategy The search included both published and unpublished studies with an initial limited search of MEDLINE and CINAHL data bases undertaken to identify key words contained in the title or abstract , and index terms used to describe relevant interventions . A second extensive search used all identified key words and index terms . The third step included a search of the reference lists and bibliographies of relevant articles . The data bases search ed included : CINAHL , MEDLINE , Current Contents , Cochrane Library , Exp and ed Academic Index , and Embase . The Dissertation Abstract s International data base was search ed for unpublished studies . Assessment of method ological quality Method ological quality was assessed using a st and ardised checklist . Critical appraisal and data extraction were conducted by two independent review ers ; discrepancies were addressed through discussion with a third review er as required . Results There was no significant difference in infection rate using either sterile surgical or non‐sterile insertion technique . The use of water for cleansing prior to catheter insertion was recommended . There was no additional benefit from specific meatal care other than st and ard daily personal hygiene and removal of debris . Infection rates were similar for both latex and silicone catheters . Comparisons between silver and Teflon coating clearly favoured the silver alloy coating . The use of a complex closed drainage system in the intensive care environment did not confer any additional benefit . Studies comparing types of junction seals and use of junction seals either prior to or following catheterisation found no clear benefit from using either preconnected sealed systems or sealed systems with the addition of silver releasing devices . Neither the addition of chlorhexidine nor hydrogen peroxide to the drainage bag was found to be effective at reducing UTI rates . The findings indicated there was a higher incidence of bacteriuria associated with Foley catheters compared with intermittent catheterisation ( P < 0.025 ) . A single RCT examined the effect on UTI rates of routine bag changes against no routine bag change . Routine bag changes were not advantageous in reducing the risk of infection . Conclusions Current RCT evidence suggests the use of a surgical sterile catheterisation technique is not required , and that tap water is sufficient for cleaning genitalia . Following insertion , daily hygiene around the meatal area is as effective as catheter toilets ; and catheters impregnated with silver may reduce the incidence of catheter associated bacteriuria . Sealed ( e.g. taped , presealed ) drainage systems should not be relied upon as the sole mechanism for prevention of bacteriuria . The addition of antibacterial solutions to drainage bags and the routine change of drainage bags had no effect on catheter associated infection . However , most of the recommendations arising from this review were based on single studies , often with limited numbers of participants . There is an urgent need to replicate these studies in other clinical setting OBJECTIVES To compare the performance of SpeediCath hydrophilic-coated catheters versus uncoated polyvinyl chloride ( PVC ) catheters , in traumatic spinal cord injured patients presenting with functional neurogenic bladder-sphincter disorders . METHODS A 1-year , prospect i ve , open , parallel , comparative , r and omised , multi centre study included 123 male patients , > or = 16 y and injured within the last 6 months . Primary endpoints were occurrence of symptomatic urinary tract infection ( UTI ) and hematuria . Secondary endpoints were development of urethral strictures and convenience of use . The main hypothesis was that coated catheters cause fewer complications in terms of symptomatic UTIs and hematuria . RESULTS 57 out of 123 patients completed the 12-month study . Fewer patients using the SpeediCath hydrophilic-coated catheter ( 64 % ) experienced 1 or more UTIs compared to the uncoated PVC catheter group ( 82 % ) ( p = 0.02 ) . Thus , twice as many patients in the SpeediCath group were free of UTI . There was no significant difference in the number of patients experiencing bleeding episodes ( 38/55 SpeediCath ; 32/59 PVC ) and no overall difference in the occurrence of hematuria , leukocyturia and bacteriuria . CONCLUSIONS The results indicate that there is a beneficial effect regarding UTI when using hydrophilic-coated catheters To evaluate whether patients performing clean intermittent self‐catheterization ( CISC ) for a short period preferred a prelubricated , hydrophilic , disposable polyvinyl chloride ( PVC ) catheter or a non‐hydrophilic PVC catheter which could be used several times and that had to be lubricated by the patient This study examined the difference in  postoperative bacteriuria in total joint arthroplasty after use of either an indwelling catheter or intermittent catheterization .  Previous studies showed a preference for an indwelling catheter over intermittent catheterization to resolve postoperative urinary retention in total joint arthroplasty , but these studies generally used 48 hours of antibiotic prophylaxis . Increasing awareness of costs and bacterial resistance to antibiotics have prompted many centers to reduce prophylaxis to only 1 preoperative dose A prospect i ve , r and omized , controlled trial was conducted in primary total hip and primary total knee arthroplasty patients . One dose of cefazolin , 1 g , was administered intravenously immediately preoperatively . Five of 13 ( 38 % ) men in the indwelling catheter group and 0 of 14 ( 0 % ) men in the intermittent catheterization group developed postoperative bacteriuria ( P = .016 ) , and 6 of 33 ( 18 % ) women in the indwelling catheter group and 3 of 39 ( 8 % ) women in the intermittent catheterization group developed postoperative bacteriuria ( not significant ) . A total of 11 ( 24 % ) patients in the indwelling catheter group ( n = 46 ) and 3 ( 6 % ) patients in the intermittent catheterization group ( n = 53 ) developed postoperative bacteriuria ( P = .018 ) . In this setting with 1-dose antibiotic prophylaxis , intermittent catheterization result ed in a lower incidence of postoperative bacteriuria compared with an indwelling catheter .  For men , this difference is significant Introduction : The aim of the present study is to compare a hydrophilic catheter to the st and ard polyvinyl chloride catheter with regard to bacteriological safety and overall comfort in patients undergoing intravesical immuno- or chemotherapy for bladder cancer . Material s and Methods : One hundred patients ( 80 males , 20 females ; median age 65.8 years , range 48–79 years ) eligible for intravesical prophylaxis of superficial bladder cancer recurrences were r and omized to receive intravesical therapy  using a st and ard catheter ( group A , n = 50 ) or a hydrophilic catheter ( group B , n = 50 ) . Urinalysis and urine culture were performed 2 days after catheterization . Comfort during catheterization was assessed by a 5-point visual analogue scale at the end of the first four instillations . Results : Urinary tract infection ( UTI ) was detected in 7.4 % of catheterizations in group A , whereas it occurred in 3.5 % of catheterizations in group B ( p < 0.01 ) . Escherichia coli was the most frequent pathogen regardless of the device used . At the end of each of the first four instillations , the mean score for discomfort was significantly higher in group A than in group B ( p < 0.001 ) , although catheterization was progressively better tolerated regardless of the device used ( both p < 0.005 ) . None of the patients were found to be suffering from orchitis , epididymitis or gross haematuria . Conclusion : Hydrophilic catheters may be used safely and are well tolerated by patients undergoing intravesical immuno- or chemotherapy . The hydrophilic catheter was associated with a significantly lower occurrence of UTI and higher acceptability compared to the st and ard device . These data should be considered with regard to patient compliance with intravesical therapy In a previous study , patients with spinal cord injuries were observed to have a high incidence of colonizaion of the perineum , rectum , and urethra with Pseudomonas . In the current report , 10 men and 10 women with spinal cord injury were studied prospect ively during their stay in hospital between June-Dec . 1977 ( men ) and Jan.-Nov . 1978 ( women ) . Colonization seen in men ( 9/10 men : 14 episodes ) was significantly more frequent than colonization in women ( 3/10 women : 5 episodes ) . Pseudomonas persisted in two or three sites for up to 105 days ( mean 47 days ) and serotyping showed that colonization was constant with one or two serotypes . Initial colonization occurred most frequently in the perineum and /or rectum . Colonization of the perineum was significantly more frequent than colonization of the rectum or urethra in men . Fifteen episodes of bacteriuria occurred only after ( or with ) colonization of perineum , urethra , and rectum . Rates of urethral colonization with Pseudomonas were higher in patients with external condom catheters than patients not using the external codon catheter 
    Output:
    
The catheter surface becomes smooth and very slippery .
This slippery surface remains intact upon insertion into the urethra and maintains lubrication through the length of the urethra .
It has been suggested that because the hydrophilic catheters do not require manual lubrication they are more sterile and thus less likely to cause infection .
The RCTs reported conflicting results regarding the effectiveness of the hydrophilic catheters compared with st and ard catheters in terms of rates of UTIs .
CONCLUSIONS Patients requiring intermittent catheterization use , on average , 4 to 5 intermittent catheters per day .
Patients admitted to hospitals using intermittent catheters typically do not reuse catheters , owing to the potential increased risk of infection in hospital .
Patients self-catheterizing at home are more likely to reuse catheters .
At this time there is insufficient evidence to indicate whether hydrophilic catheters are associated with a lower rate of UTIs and improved patient satisfaction among people requiring intermittent catheterization