***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 
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    Input: PURPOSE To evaluate the hypothesis that a 7-day period of indwelling catheter after radical retropubic prostatectomy  is effective and safe without the need of performing cystography . METHODS In the period from January of 2000 to July of 2002 , 73 patients underwent radical retropubic prostatectomy  , and these patients were prospect ively r and omized in 2 groups : Group 1 - 37 patients who had the urethral catheter removed 7 days after the procedure , and Group 2 - 36 patients who had the  catheter removed 14 days after the surgery . The 2 groups were similar , the surgeons and the technique were the same , and no cystography was performed to evaluate the presence of leaks . RESULTS Two patients in Group 1 had bleeding and clot retention after having the catheter taken out in the seventh postoperative day and were managed by putting the catheter back in for 7 more days . Two patients in Group 2 developed bladder neck stricture and were treated by bladder neck incision with success . The continence rate was the same , with 2 cases of incontinence in each group . About 2 pads a day were used by the patients with incontinence . The average follow-up was 17.5 months ( 12 - 36 months ) . No urinary fistula , urinoma , or pelvic abscesses developed after catheter removal . Two patients were excluded from the analysis of this series : 1 died with a pulmonary embolus in the third postoperative day , and 1 developed a urinary suprapubic fistula before catheter withdrawal , which was maintained for 16 days . CONCLUSION Withdrawal of the urethral catheter 7 days after radical retropubic prostatectomy , without performing cystography , has a low rate of short-term complications that are equivalent to withdrawal 14 days after the surgery OBJECTIVES To compare the safety , effectiveness and patient satisfaction of an intraurethral valve-pump catheter ( In-Flow ) versus the current st and ard of care , clean intermittent catheterization ( CIC ) , for females with hypocontractile or acontractile bladder . MATERIAL S AND METHODS The study was a multi-centre , prospect i ve , single-arm crossover study . Eligible patients underwent a 1-week In-Flow tolerability trial . Successful patients then continued through an 8-week baseline phase using CIC , followed by a 16-week In-Flow treatment phase , and a final 4-week treatment withdrawal phase . Outcome measures included post-void residual ( PVR ) , Wagner incontinence-specific quality of life ( I-QOL ) , rate of urinary tract infection and adverse events . At study completion , open enrollment was offered . RESULTS A total of 273 women with a mean age of 48.9 years using CIC  entered the study in 18 centres under either the original ( n=88 ) or revised protocol s ( n=185 ) . The revised protocol included the addition of a 1-week tolerability trial . The reasons for the large early withdrawal of subjects ( 169/273 ) were mainly related to initial discomfort and leakage . A total of 77 patients completed the In-Flow treatment phase . PVR was comparable during baseline CIC phase and In-Flow treatment phase ( 20.3 ml vs. 16.1 ml ) , with significantly improved quality of life ( QOL ; mean improvement of I-QOL score + 25.9 ; p<0.001 ) . CONCLUSION The In-Flow catheter appears to be a viable alternative to CIC . A subgroup of patients , mainly those unsatisfied with the currently available treatments , was more likely to tolerate In-Flow catheters , and they may achieve enhanced independence and QOL Thirty-four elderly in patients with long-term urethral catheters were r and omly assigned to receive either norfloxacin ( 200 mg/day ) or placebo in a double-blind study with cross-over after three months . Twenty-three patients completed the entire study . Norfloxacin treatment was associated with a persistent decrease in gram-negative isolates ( p<0.005 ) and the acquisition of gram-positive norfloxacin-resistant flora . It also result ed in a highly statistically significant reduction of symptomatic urinary tract infections ( 1 vs. 12 , p<0.02 ) , a decrease in catheter-associated local complications , obstructions and leakage ( p<0.05 ) and an improvement in the patients ' general condition ( p<0.001 ) . In conclusion , within the conditions of the present study , long-term suppression of gramnegative bacteriuria by norfloxacin reduced the incidence of catheter-related urinary tract infection and associated morbidity OBJECTIVES To compare the use of intermittent and indwelling catheterization in older female patients with urinary retention . METHODS A r and omized , 2-week prospect i ve study in a geriatric rehabilitation ward . Female patients of age 65 years and older with post-voiding residual urine volume ( PVRU ) persistently > or = 300 ml were r and omly assigned to one of the two groups : intermittent catheterization ( IMC group , n=36 ) and indwelling catheterization ( IDC group , n=45 ) . The primary outcome was the proportion of subjects being catheter-free and had a PVRU < 150 ml on day 14 . The secondary outcomes were the time to become catheter-free and the rate of bacteriuria on day 14 . RESULTS Sixteen out of 27 ( 59.3 % ) in the IMC group versus 27 out of 39 ( 69.2 % ) in the IDC group achieved the primary outcome on day 14 ( P=.403 ) without significant difference in the PVRU . The IMC and IDC groups took a mean of 8.6+/-3.3 and 9.2+/-4.0 days to become catheter-free , respectively ( P=.609 ) . Fourteen out of 22 ( 63.6 % ) in the IMC group versus 21 out of 34 ( 61.8 % ) in the IDC group had bacteriuria on day 14 ( P=.888 ) . CONCLUSION Given the similar success rate of regaining bladder voiding function , the similar rate of bacteriuria and considering that the IMC group only underwent a median of 3 times of intermittent catheterization , we believe that the approach of intermittent urinary catheterization when required would be justified in managing elderly female urinary retention in rehabilitation ward as the presence of indwelling catheters would hinder rehabilitation and adversely affect patient quality of life OBJECTIVES To compare condom and indwelling urinary catheters in terms of infection risk and patient satisfaction . DESIGN A prospect i ve , r and omized , unblinded , controlled trial . SETTING An academically affiliated Veterans Affairs Medical Center . PARTICIPANTS Hospitalized men aged 40 and older who required a urinary collection device . MEASUREMENTS The incidence of adverse outcomes ( bacteriuria , symptomatic urinary tract infection ( UTI ) , or death ) and patient device-related satisfaction as determined according to a question naire . Dementia status was recorded to assess effect modification by the presence of dementia . RESULTS Seventy-five subjects were r and omized : 41 receiving an indwelling catheter and 34 a condom catheter . The incidence of an adverse outcome was 131/1,000 patient-days with an indwelling catheter and 70/1,000 patient-days with a condom catheter ( P=.07 ) . The median time to an adverse event was 7 days in the indwelling group and 11 days in the condom group . After adjusting for other risk factors , it was found that condom catheter use reduced adverse outcomes ( P=.04 ) . Patients without dementia who had an indwelling catheter were approximately five times as likely to develop bacteriuria or symptomatic UTI or to die ( hazard ratio=4.84 , 95 % confidence interval=1.46 - 16.02 ) as those with a condom catheter ( P=.01 ) . Patients reported that condom catheters were more comfortable ( P=.02 ) and less painful ( P=.02 ) than indwelling catheters . CONCLUSION The use of condom catheters is less likely to lead to bacteriuria , symptomatic UTI , or death than the use of indwelling catheters . This protection is especially apparent in men without dementia OBJECTIVE To determine the pathogenesis of catheter-associated urinary tract infection ( CAUTI ) and the relative importance of each of the possible mechanisms of entry of infecting microorganisms to the catheterized urinary tract . MATERIAL AND METHODS We conducted a prospect i ve study of 1,497 newly catheterized patients . Paired quantitative urine cultures were obtained daily , from the catheter specimen port and from the collection bag , using a technique that could detect 1 colony-forming unit/mL. We assumed that with extraluminal infections , caused by microorganisms ascending from the perineum in the mucous film contiguous to the external surface of the catheter , the organisms would be detected first in bladder urine or in far higher concentrations in urine from the specimen port than from the collection bag . With intraluminal CAUTIs , caused by microorganisms gaining access to the catheter lumen because of failure of closed drainage or contamination of collection bag urine , the organisms would be detected first or in far larger numbers in a collection bag specimen . RESULTS The probable mechanism of infection could be determined for 173 of 250 organisms ( 69.2 % ) identified in 235 new-onset CAUTIs . Among these 173 cases , 115 ( 66 % ) were extraluminally acquired , and 58 ( 34 % ) were derived from intraluminal contaminants . For these determinable cases , CAUTIs caused by gram-positive cocci ( enterococci and staphylococci ) and yeasts were far more likely to be extraluminally acquired ( extraluminal : intraluminal , 2.9 ) than were gram-negative bacilli , which caused CAUTIs by both routes equally ( extraluminal : intraluminal , 1.2 ; P = 0.007 ) . Surprisingly , no significant differences were noted in pathogenetic mechanisms between men and women . CONCLUSION We conclude that , in both men and women , CAUTIs occur by both extraluminal and intraluminal portals of entry but derive preponderantly from organisms that gain access extraluminally . Strategies for prevention of CAUTIs must focus on new technologies to prevent access of organisms by all possible routes BACKGROUND / PURPOSE Clean intermittent catheterization has been an established practice for more than 3 decades . The validity of antibiotic prophylaxis has been question ed although not tested . METHODS Eighty-five patients were recruited into a r and omized controlled trial . The r and omization involved the placement into 1 of 2 groups : ( A ) continuing antibiotics or ( B ) discontinuing antibiotics . The trial would last 4 months with the outcome being a confirmed urinary tract infection . All groups were matched for age , sex , and pathology . RESULTS The incidence of urinary tract infections was significantly increased in the group who continued to use antibiotics ( n = 20 ) when compared with the group who discontinued prophylaxis ( n = 3 ) . The common infecting organism was Escherichia coli . CONCLUSIONS The use of prophylactic antibiotics for children who intermittently catheterize may not be necessary . The use of prophylactic antibiotics may result in increased rates of infection because of the development of resistant organisms We conducted 202 trials in 161 male hospital patients to determine if prophylactic administration of ascorbic acid or antibacterials ( trimethoprim-sulfamethoxazole , nalidixic acid , methenamine hippurate or nitrofurantoin macrocrystals ) would prevent bacteriuria infections in spinal cord injury patients who had had at least 1 bout of bacteriuria . None of the drugs tested appeared to be statistically effective in the doses used in preventing bacteriuria in these patients . Moreover , sensitivities were lost to several drugs other than those used prophylactically . We conclude that use of prophylactic doses of ascorbic acid or antibacterials has not proved to be beneficial in spinal cord injury patients free of indwelling catheters OBJECTIVE To determine the potential benefits of ISC ( intermittent self-catheterisation ) over SPC ( supra-pubic catheterisation ) in the post-operative bladder care of women following radical hysterectomy . METHODS A prospect i ve r and omised controlled trial of women treated by radical hysterectomy for early stage cervical cancer . RESULTS . : 40 women were recruited to the study , 21 to ISC and 19 to SPC . All patients r and omised to ISC were able to learn the technique of ISC satisfactorily following a period of pre-operative training . The day 3 and day 5 positive CSU ( catheter specimen of urine ) rate was significantly higher in the ISC group ( 42 % and 63 % ) compared to the SPC group ( 6 % and 18 % ) , P = 0.05 and P = 0.004 , respectively ) . Eight of 17 patients r and omised to SPC ( 47 % ) documented having symptoms/problems arising from the SPC site of which 4 ( 2 
    Output:
    
For patients using intermittent catheterisation , there were inconsistent findings about the effect of antibiotic prophylaxis on symptomatic urinary tract infection ( UTI ) .
For patients using intermittent catheterisation , there was limited evidence that receiving antibiotics reduced the rate of bacteriuria ( asymptomatic and symptomatic ) .
There was weak evidence that prophylactic antibiotics were better in terms of fewer symptomatic bacteriuria .