***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: A clinical trial comparing two intermittent catheterization techniques used with spinal cord injured patients at Parkwood Hospital , a long-term care facility in London , ON , Canada , was conducted to evaluate the techniques ' effect on urinary tract infections ( UTIs ) . Charts were review ed retrospectively for 92 patients with traumatic spinal cord injury who were on intermittent catheterization between January 1985 and December 1988 . Nearly 80 % of these patients had more than one UTI per admission . A convenience sample of 18 patients with traumatic spinal cord injury participated in a prospect i ve study using a no-touch method of catheterization for 7 months . Preliminary findings at the completion of the study revealed that 44.4 % of this experimental group had more than one UTI per admission -- a 44.5 % reduction . The no-touch method using the O'Neil Sterile Field urinary catheter was successful in reducing the total number of infections and duration of infection for the experimental group . A nurse satisfaction question naire revealed that nursing staff preferred this method of intermittent catheterization to the traditional method RésuméUne étude prospect i ve r and omisée chez les patients opérés pour une arthrodèse rachidienne a permis d'étudier l'effet du sondage uréthral à demeure sur les complications urinaires . Deux groupes de patients ont été formés ; 16 d'entre eux ont reçu une sonde urinaire à demeure et 16 autres n'ont pas été sondés . Tous les patients ont été en cas de nécessité , sondés de manière intermittente dans la phase postopératoire . Sept des patients du groupe sondé présentaient des cultures positives à un taux ≥100000 bactéries vivantes/ml , contre deux patients seulement dans le groupe non sondé ( ns ) . Un autre groupe de 4 patients du groupe non sondé présentaient des cultures positives à un taux ≥10000 bactéries vivantes/ml . Treize patients du groupe sondé et 14 patients du groupe non sondé présentaient des tests à la b and elette positifs . La plus gr and e quantité d'urine recueillie chez chaque patient lors d'un cathétérisme intermittent ne différait pas de manière significative entre les groupes . Cependant , chez trois patients du groupe non sondé les volumes dépassaient 1000 ml . Ainsi , quel qu'ait été le traitement , 84 % des patients ont eu une surveillance bactériurique par des tests à la b and elette . Le sondage urinaire à demeure au cours de l'opération ne semble pas provoquer plus de complications infectieuses que l'absence de drainage vésical peropératoire ; les avantages liés à la diminution du risque de lésion vésicale par distension et à la surveillance plus précise de l'équilibre liquidien incitent à utiliser ce type de cathétérisme . Summary In a prospect i ve r and omized study the effect of the use of an intraoperative indwelling urethral catheter ( IUC ) on urinary complications was investigated in patients undergoing spinal fusion . Two groups were formed ; 16 patients received an  intraoperative IUC  and 16 patients had no intraoperative catheter ( NC ) . All patients were , if necessary , intermittently catheterized in the postoperative period . Seven of the patients in the IUC group had positive cultures , defined as ≥100000 CFU/ml , compared with two patients in the NC group ( n.s . ) . Another four patients in the NC group had cultures ≥10000 CFU/ml . Thirteen patients in the IUC group and 14 patients in the NC group had positive dip slides . The largest received urine volume in each patient at one intermittent catheterization did not differ significantly between the groups . However , in three patients in the NC group the volumes exceeded 1000 ml . Thus , irrespective of treatment dip slides showed bacteriuria in 84 % of the patients . Perioperative indwelling catheters do not seem to cause many more infection complications than no bladder drainage during surgery , and the advantages of reduced risk of bladder distension injury and more accurate monitoring of fluid balance suggest their use 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 OBJECTIVES To compare the safety and cost of  clean versus sterile intermittent bladder catheterization in male nursing home residents . To provide evidence to support the hypothesis that intermittent catheterization is a valid , alternative method of bladder management in male residents of long-term care in whom urinary retention is a documented problem . DESIGN R and omized clinical trial . SETTING Three long-term care sites having predominantly male population s. PARTICIPANTS Eighty male veterans , residents of three long-term care facilities , ranging in age from 36 to 96 years with a mean age of 72 . INTERVENTIONS St and ardized procedures for clean and sterile intermittent catheterization ( IC ) were implemented by staff nurses at each site . Patients were r and omized into clean and sterile IC groups . Nursing time and catheterization equipment usage were recorded using bar code readers . Clinical data were collected from the medical chart . Treatment of urinary tract infection was prescribed by the medical personnel responsible for each individual resident . MEASUREMENTS We compared the number of treatment episodes for symptomatic bacteriuria between groups r and omized to receive either clean or sterile intermittent catheterization . Laboratory analysis of blood and urine was done on predetermined days . Control variables were research site and patient history of urinary tract infection within the last 6 months . A cost comparison of nursing time and equipment usage for the two catheterization techniques was also performed . RESULTS No significant differences were found between clean and sterile groups with regard to number of treatment episodes , time to first infection , type of organism cultured , or cost of antibiotic treatment . The cost of sterile technique  was considerably higher both in terms of nursing time and supplies . CONCLUSIONS Findings from this study demonstrate that clean technique intermittent catheterization is a safe and cost-effective bladder management technique with male , nursing home residents , despite the frailty of this high risk population . An annual savings of approximately $ 1460 per patient in nursing time and catheterization supplies could be anticipated if a patient were catheterized an average of four times per day substituting clean IC technique for sterile IC technique Monthly urine cultures were analyzed at the University of Alberta Department of Medical Microbiology and Infectious Diseases to determine whether single-use sterile catheters and clean technique reduced the incidence of bacterial colonization in those using long-term intermittent self-catheterization . Thirty subjects with spina bifida , ages 3 years to 16 years , entered a crossover study with r and om assignment to 6 months of sterile single-use catheters or clean reused catheters .  Seventeen subjects were catheterized by a parent or caregiver ; 13 were responsible for self-catheterization and cleaning of the catheters . Six months of descriptive data were also collected at Alberta Children 's Hospital from a similar group of subjects with spina bifida who used sterile catheters only . In the crossover group , 38 % of all urine cultures were positive regardless of whether sterile single-use or clean reused catheters were employed . The other group using only sterile catheters had a 36 % positive culture rate . No difference in positive cultures was found between males and females or between children who catheterized themselves and children whose parents catheterized them . The authors concluded that plastic urethral catheters may be reused The purpose of this study was to compare the incidence of urinary infection following sterile catheterisation after either ( 1 ) a h and wash of 30 s and double gloving , ( the shorter sterile technique ) or ( 2 ) after a 3 minute wash from fingertips to elbows and the wearing of a sterile gown and one pair of gloves , ( the longer sterile technique ) . Forty-six patients were r and omly assigned to the two groups . No significant difference in urinary infection rates was found and as a result the more complicated technique has been 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 This study was design ed to determine the effect of sterile and nonsterile intermittent catheterization on the incidence of urinary tract infection ( UTI ) in patients after spinal cord injury . The study included 29 patients with neurogenic bladder dysfunction treated with intermittent catheterization .  One group of 14 patients was on  sterile catheterization ;  another group of 15 patients was on nonsterile catheterization .  On a weekly basis , urine sample s were obtained and analyzed . A total of 122 urine sample s were analyzed . The patients on sterile catheterization had a 28.6 % UTI incidence ; the group using a nonsterile catheterization technique had a UTI incidence of 42.4 % . The most common urinary pathogen in both groups was E. coli ( 65 % ) . The cost of antibiotics  for patients on the sterile catheterization program was only 43 % of the cost of antibiotics for those on the nonsterile program . However , the sterile kits cost 371 % of the cost 
    Output:
    
There is a lack of evidence to state that incidence of UTI is affected by use of sterile or clean technique , coated or uncoated catheters , single ( sterile ) or multiple use ( clean ) catheters , self-catheterisation or catheterisation by others , or by any other strategy .
Based on the current data , it is not possible to state that one catheter type , technique or strategy is better than another