***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Objective To evaluate urethral catheter ( UC ) versus suprapubic tube ( SPT ) without stenting the anastomosis at robot-assisted radical prostatectomy ( RALP ) regarding surgical outcome and catheter-associated discomfort . One year after surgery , continence and patient satisfaction were evaluated . Material s and methods Sixty-two patients undergoing RALP were prospect ively r and omized to urinary drainage with UC or with SPT .  Functional results were assessed with st and ardized question naires ( IPSS , IPSS Bother Score , IIEF and Visual Analogue Scale ) preoperatively , after catheter removal and 1 year after surgery . Moreover , bother by the catheter as well as pain due to the catheter was assessed . Results At personal hygiene , SPT was significantly less bothersome on the day of surgery as well as POD 1–6 . Pain caused by the catheter did not differ significantly between the two groups except for POD 5 and 6 , when the SPT performed significantly better . Differences regarding voiding parameters after catheter removal did not reach statistical significance . One year after surgery , no significant difference between the two groups was found regarding urinary function and IPSS . Though not statistically significant either , the need for the incision of bladder neck contracture ( BNC ) in two patients in the UC group is of note , as in the SPT group , no BNC occurred . Conclusion Draining the bladder with SPT only is a feasible option in patients undergoing RALP . Patients with SPT are significantly less bothered by the catheter at personal and genital hygiene compared to UC . The risk of BNC seems to be reduced in the SPT group BACKGROUND Robot-assisted radical prostatectomy ( RARP ) is a widespread option for the treatment of patients with clinical ly localised prostate cancer . Modifications in the surgical technique may help to further improve functional outcomes . OBJECTIVE To assess the outcome of early catheter removal 48h after surgery , as opposed to st and ard catheter removal 6 d after surgery following RARP , using a newly developed surgical technique for posterior reconstruction and anastomosis ( Aalst technique ) . DESIGN , SETTING , AND PARTICIPANTS Patients scheduled for RARP were prospect ively scheduled for early catheter removal at postoperative d 2 ( group A , n=37 ) and st and ard catheter removal at postoperative d 6 ( group B , n=37 ) . SURGICAL PROCEDURE RARP was performed using the Da Vinci Si system . The Aalst technique for the urethro-vesical anastomosis including posterior reconstruction was used as previously described . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary endpoint was spontaneous voiding after catheter removal . Secondary endpoints were rate of anastomotic urinary leakage after catheter removal , presence and severity of urethral , perineal , and abdominal pain , as well as patient 's bother after catheter removal using visual analogue scale ( VAS ) scores . Rate and severity of urinary incontinence after catheter removal were assessed using the International Consultation on Incontinence Question naire-Male Lower Urinary Tract Symptoms Module ( ICIQ-MLUTS ) question naire . RESULTS AND LIMITATIONS There was no significant difference between the groups with regard to baseline and perioperative parameters , as well as pathological features ; however , significantly more patients underwent bilateral nerve-sparing procedures in group A ( 34 vs 23 , p=0.008 ) . After catheter removal , patients in both groups showed spontaneous voiding , whereas only 11 % and 8 % of the patients in group A and group B experienced urinary retention after catheter removal ( p=0.7 ) . Patients in group B had significantly higher maximum flow rates , but lower voided volumes after catheter removal in comparison with patients in group A ( 21ml/s vs 10ml/s , p≤0.001 and 170ml vs 200ml , p≤0.001 , respectively ) . ICIQ-MLUTS question naire and VAS scores showed no significant differences between the groups at any time point . CONCLUSIONS The Aalst technique allows the removal of catheters 2 d after RARP and results in spontaneous voiding . Early removal showed no increased rate of urinary leakage , no negative impact on short-term continence and on perineal , urethral or penile pain , and no increase in urinary retention rates . Future studies have to confirm these results with longer follow-up including detailed parameters on return to daily activity . PATIENT SUMMARY We provide evidence that it is possible to remove the bladder catheter as early as 2 d after robot-assisted radical prostatectomy without any negative effects on voiding and pain parameters . Thus , leaving the hospital early without a catheter in place could represent a significant and relevant benefit for the patient PURPOSE Retrospective single institution data suggest that postoperative pain after  robot-assisted laparoscopic radical prostatectomy  is decreased by early removal of the urethral catheter with suprapubic tube drainage . In a r and omized patient population we determined whether suprapubic tube drainage with early urethral catheter removal would improve postoperative pain compared with urethral catheter drainage alone . MATERIAL S AND METHODS Men with a body mass index of less than 40 kg/m(2 ) who had newly diagnosed prostate cancer and elected robot-assisted laparoscopic radical prostatectomy were included in analysis . Block r and omization by surgeon was used and r and omization assignment was done after completing the urethrovesical anastomosis . In patients assigned to suprapubic tube drainage the urethral catheter was removed on postoperative day 1 and all catheters were removed on postoperative day 7 . Visual analog pain scale and satisfaction question naires were administered on postoperative days 0 , 1 and 7 . RESULTS A total of 29 patients were r and omized to the urethral catheter vs 29 to the suprapubic tube plus early urethral catheter removal at the time of interim futility analysis . Mean visual analog pain scale scores did not differ between the groups at any time point and a similar percent of patients cited the catheter as the greatest bother with nonsignificant differences in treatment related satisfaction . Complications during postoperative week 1 did not vary between the groups . Based on interim results the trial was terminated due to lack of effect . CONCLUSIONS Patients r and omized to suprapubic tube vs urethral catheter drainage for the week after prostatectomy had similar pain , catheter related bother and treatment related satisfaction in the perioperative period . We no longer routinely offer suprapubic tube drainage with early urethral catheter removal at our institution BACKGROUND The literature is lacking r and omised controlled trials comparing robot-assisted ( RARP ) and laparoscopic ( LRP ) radical prostatectomy , especially for follow-up > 1 yr . OBJECTIVE To report 5-yr outcomes for our previously published prospect i ve r and omised study comparing RARP and LRP . DESIGN , SETTING , AND PARTICIPANTS From January 2010 to January 2011 , 120 patients with organ-confined prostate cancer were enrolled and r and omly assigned to RARP or LRP . INTERVENTION A single surgeon performed all interventions using the same transperitoneal antero grade technique . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Continence , potency , and serum prostate-specific antigen were assessed postoperatively at 1 , 3 , 6 , and 12 mo , and then every 6 mo until 60 mo . At the end of the follow-up period , patients were administered questions 1 and 46 of the Exp and ed Prostate Cancer Index Composite question naire to assess their satisfaction with the intervention and general health status . A generalised estimating equations model was used to compare time series data for functional results , and Kaplan-Meier and Cox models were used to analyse oncologic outcomes . RESULTS AND LIMITATIONS The probability of achieving continence ( odds ratio [ OR ] 2.47 , p<0.021 ) and potency ( OR 2.35 , p<0.028 ) over time was more than doubled for the RARP compared to the LRP group . There was no difference between the two approaches in terms of patient survival . Pathologic Gleason score , positive surgical margins , and pT stage were associated with significantly higher biochemical recurrence in Cox multivariate models . Patient satisfaction with the intervention and their general health status was significantly higher in the RARP group . CONCLUSIONS Throughout the 5-yr follow-up , RARP yielded better functional results compared to LRP , without compromising oncologic outcomes . PATIENT SUMMARY In this report we looked at 5-yr outcomes for a study comparing robot-assisted radical prostatectomy ( RARP ) and laparascopic radical prostatectomy for the treatment of prostate cancer . We found that continence and potency are better among patients treated with RARP , while oncologic results are comparable BACKGROUND More than a decade since its inception , the benefits and cost efficiency of robot-assisted radical prostatectomy ( RARP ) continue to elicit controversy . OBJECTIVE To compare outcomes and costs between RARP and open RP ( ORP ) . DESIGN , SETTING , AND PARTICIPANTS A cohort study of 629 593 men who underwent RP for localized prostate cancer at 449 hospitals in the USA from 2003 to 2013 , using the Premier Hospital Data base . INTERVENTION RARP was ascertained through a review of the hospital charge description master for robotic supplies . OUTCOME MEASURES AND STATISTICAL ANALYSIS Outcomes were 90-d postoperative complications ( Clavien ) , blood product transfusions , operating room time ( ORT ) , length of stay ( LOS ) , and direct hospital costs . Propensity-weighted regression analyses accounting for clustering by hospitals and survey weighting ensured nationally representative estimates . RESULTS AND LIMITATIONS RARP utilization rapidly increased from 1.8 % in 2003 to 85 % in 2013 ( p<0.001 ) . RARP patients ( n=311 135 ) were less likely to experience any complications ( odds ratio [ OR ] 0.68 , p<0.001 ) or prolonged LOS ( OR 0.28 , p<0.001 ) , or to receive blood products ( OR 0.33 , p=0.002 ) compared to ORP patients ( n=318 458 ) . The adjusted mean ORT was 131min longer for RARP ( p=0.002 ) . The 90-d direct hospital costs were higher for RARP ( + $ 4528 , p<0.001 ) , primarily attributed to operating room and supplies costs . Costs were no longer signficantly different between ORP and RARP among the highest-volume surgeons ( ≥104 cases/yr ; + $ 1990 , p=0.40 ) and highest-volume hospitals ( ≥318 cases/yr ; + $ 1225 , p=0.39 ) . Limitations include the lack of oncologic characteristics and the retrospective nature of the study . CONCLUSIONS Our contemporary analysis reveals that RARP confers a perioperative morbidity advantage at higher cost . In the absence of large r and omized trials because of the widespread adoption of RARP , this retrospective study represents the best available evidence for the morbidity and cost profile of RARP versus ORP . PATIENT SUMMARY In this large study of men with prostate cancer who underwent either open or robotic radical prostatectomy  , we found that robotic surgery has a better morbidity profile but costs more The purpose of this work was to assess the feasibility of urethral catheter removal  3 days after radical retropubic prostatectomy ( RRP ) . Twenty-two patients who underwent RRP with a watertight eight-suture vesicourethral anastomosis had their urethral catheter removed usually on postoperative day ( POD ) 3 . The average day of urethral catheter removal was POD 3.2 . At 3 months , 56 % of patients required no or one protective pad to stay dry and 68.4 % of patients ‘ never leaked ’ or ‘ leaked occasionally ’ . Following RRP , the urethral catheter can be removed as early as POD 3 if the intraoperative anastomosis is watertight without compromising urinary continence Purpose To evaluate the impact of the type of  urinary diversion ( suprapubic vs. transurethral catheterization ) on patients ’ postoperative pain after radical prostatectomy , development of bacteriuria and long-term functional results . Methods A r and omized , prospect i ve clinical trial was performed including 160 patients who underwent robot-assisted radical prostatectomy after r and omization into two groups : intraoperatively , a transurethral catheter ( control group ) or an additional suprapubic tube ( with removal of the transurethral catheter in the morning of postoperative day 1 ; intervention group ) was placed . Primary study endpoint was postoperative pain objectified by the numeric rating scale question naire . Secondary endpoints were bacteriuria after catheter removal and functional outcomes after up to 2 years of follow-up . Results There were no significant differences in demographic and perioperative data . Starting on postoperative day 2 , patients in the suprapubic diversion group had significantly less pain on every time point preceding the removal of the catheter compared to the control cohort with a median overall numeric rating score on postoperative day 1–4 of 2.4 points in the transure 
    Output:
    
Conclusions Available evidence suggests that the use of SPC can be a viable option for postoperative urine drainage after RARP , as it can translate into decreased postoperative pain without carrying a significant higher risk of catheter-related complications .