***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: OBJECTIVES To compare the effectiveness of bacterial interference versus placebo in preventing urinary tract infection ( UTI ) . METHODS The main outcome measure was the numbers of episodes of UTI/patient-year . R and omization was computer generated , with allocation concealment by visibly indistinguishable products distributed from a core facility . The healthcare providers and those assessing the outcomes were unaware of the group allocation . Adult patients ( n = 65 ) with neurogenic bladder after spinal cord injury and a history of recurrent UTI were r and omized in a 3:1 ratio to receive either Escherichia coli HU2117 or sterile saline . Urine cultures were obtained weekly during the first month and then monthly for 1 year . The patients were evaluable if they remained colonized with E. coli HU2117 for > 4 weeks ( experimental group ) . The trial is closed to follow-up . RESULTS Of the 59 patients who received bladder inoculations , 27 were evaluable ( 17 in the experimental group and 10 in the placebo group ) . The 2 study groups had comparable clinical characteristics . Of 17 patients colonized with E. coli HU2117 and the 10 control patients , 5 ( 29 % , 95 % confidence interval 0.11 - 0.56 ) and 7 ( 70 % , 95 % confidence interval 0.35 - 0.92 ) developed > 1 episode of UTI ( P = .049 ; 1-sided Fisher 's exact test ) , respectively . The average number of episodes of UTI/patient-year was also lower ( P = .02 , Wilcoxon rank sum test ) in the experimental ( 0.50 ) than in the control group ( 1.68 ) . E. coli HU2117 did not cause symptomatic UTI . CONCLUSIONS Bladder colonization with E. coli HU2117 safely reduces the risk of symptomatic UTI in patients with spinal cord injury . Effective , but less complex , methods for achieving bladder colonization with E. coli HU2117 are under investigation A r and omized prospect i ve trial compared the effect on the bacterial flora of the urine of the instillation of chlorhexidine or of normal saline into the bladder of two groups of elderly patients with indwelling urinary catheters . There was no reduction in urinary bacterial count in either group of patients OBJECTIVES It is st and ard practice to use lignocaine gel during male urethral catheterization . However , it is commonly believed that topical anaesthetic confers no benefit during female catheterization hence lubricating gel alone is more commonly used . The present study aim ed to determine whether lignocaine gel decreased pain compared with water-based lubricating gel for female urethral catheterization in the ED . METHODS This r and omized double-blinded study was carried out at two Sydney hospitals -- an urban district inner western hospital and a south-western major trauma centre . A convenience sample of 62 alert , cooperative adult female ED patients provided written informed consent . The indications for , and technique of catheterization , were at the discretion of the clinical staff . Pre- and immediate post-procedure pain was scored by the patient on a 100 mm Visual Analogue Scale ( VAS ) . The primary outcome was the difference in VAS scores ( post- minus pre-procedure ) in millimetres . Values for each group were expressed as medians and interquartile ranges , statistical significance determined using the Mann-Whitney U-test . RESULTS The groups were well matched for age , indication for catheterization , pre-procedural pain score , catheter size and the number of catheterization attempts . Patients receiving lignocaine gel had a significantly lower median procedural pain score than patients receiving lubricating gel ( 6 mm vs 33 mm , P = 0.007 ) . CONCLUSIONS Lignocaine gel substantially reduces the procedural pain of female urethral catheterization by comparison with use of a water-based lubricating gel Thirty-eight patients with problems with their urinary catheters were r and omly treated with Varidase ® or normal saline solution once a day for 10 days . Photographs were taken by using a cystoscope before treatment , at day 10 and day 24 after the commencement of treatment . The photographs were evaluated according to the occurrence of pus , debris , coagula and rubor . In the Varidase ® group the improvements from baseline to day 10 and day 24 were statistically significant ( p < 0·05 ) in all parameters while there were no statistically significant improvements in the saline group . Comparing the two treatment groups , regarding the changes from baseline to day 10 and day 24 , it was statistically demonstrated that Varidase ® was significantly more effective than saline in all parameters ( p < 0·05 ) . In conclusion , this study shows that Varidase ® effectively cleans the urinary bladder from pus , fibrin , necrotic tissue and blood clots We have evaluated the effect of povidone-iodine ( PVP-I ) bladder irrigation prior to catheter removal on subsequent bacteriuria . Of 264 patients , 138 received PVP-I irrigation and 126 were controls . Both groups were similar with respect to duration of catheterization and bacteriuria before removal of the catheter . Of 497 cultures taken after catheter removal 99 ( 20 % ) were positive . This included 52 of 233 in the control group ( 22 % ) and 47 of 264 in the study group ( 18 % ) . Patients with positive cultures had a significantly longer period of catheterization . Our trial did not demonstrate that PVP-I bladder irrigation before catheter removal reduces subsequent bacteriuria Study design : Non-r and omized pilot trial . Objectives : To determine whether Escherichia coli 83972-coated urinary catheters in persons with spinal cord injury ( SCI ) practicing an intermittent catheterization program ( ICP )  could ( 1 ) achieve bladder colonization with this benign organism and ( 2 ) decrease the rate of symptomatic urinary tract infection ( UTI ) . Setting : Outpatient SCI clinic in a Veterans Affairs hospital ( USA ) . Methods : Participants had neurogenic bladders secondary to SCI , were practicing ICP , had experienced at least one UTI and had documented bacteruria within the past year . All participants received a urinary catheter that had been pre-inoculated with E. coli 83972 . The catheter was left in place for 3 days and then removed . Participants were followed with urine cultures and telephone calls weekly for 28 days and then monthly until E. coli 83972 was lost from the urine . Outcome measures were ( 1 ) the rate of successful bladder colonization , defined as the detection ( ⩾102 cfu ml−1 ) of E. coli 83972 in urine cultures for > 3 days after catheter removal and ( 2 ) the rate of symptomatic UTI during colonization with E. coli 83972 . Results : Thirteen participants underwent 19 insertions of study catheters . Eight participants ( 62 % ) became successfully colonized for > 3 days after catheter removal . In these 8 participants , the rate of UTI during colonization was 0.77 per patient-year , in comparison with the rate of 2.27 UTI per patient-year before enrollment . Conclusions : E. coli 83972-coated urinary catheters are a viable means of achieving bladder colonization with this potentially protective strain in persons practicing ICP The purpose of this study was to evaluate the effects of a nurse-family partnership model on the self-efficacy of family caregivers ( FCs ) and the incidence of catheter-associated urinary tract infection ( CAUTI ) among patients . A r and omized controlled study was conducted . We recruited 61 patients and their FCs , who were r and omly divided into an experimental group ( n = 30 ) and a control group  ( n = 31 ) . In the experimental group , the main caregivers comprised a nurse-family partnership , whereas the control participants received routine care . The findings were as follows : ( i ) the incidence of CAUTI was lower in the experimental group than in the control group ( 20 % vs. 38.8 % ) , but the difference was not statistically significant ; and ( ii ) no significant difference emerged for reported Caregiver Self-Efficacy Score between the two groups . The nursing team and FCs must become partners in cooperative caregiving to enhance the quality of patient care Since the long-term catheterized patient is at significant risk of urinary tract infection , and the catheter drainage bags of these patients are at significant risk of becoming reservoirs for nosocomial pathogens , we carried out a r and omized , controlled study to determine the efficacy of intermittent drainage bag instillation of hydrogen peroxide ( H2O2 ) in patients requiring indwelling Foley catheters for 5 days or more . Herein we report the effects of this technique on the rates of catheter and bag bacteriuria , the duration to positive culture , the temporal relationships observed , and the spectrum of organisms recovered . Bag source bacteriuria was found with the same frequency in both control and H2O2 groups .  H2O2 did reduce contamination of the drainage bag but did not reduce catheter-associated bacteriuria or frequency of symptomatic urinary tract infection . Furthermore , H2O2 did not reduce the frequency of bag contamination with most of the common nosocomial urinary pathogens The purpose of our investigation was to compare external sphincterotomy , the traditional method of treatment of detrusor-external sphincter dyssynergia ( DESD ) , with two newer methods , balloon dilatation or internal stenting of the external sphincter .  Sixty-one spinal cord injured ( SCI ) men were prospect ively evaluated . The indications for treatment were DESD and voiding pressure greater than 60 cmH2O demonstrated during video-urodynamic study . Twenty patients were treated with balloon dilatation of the external sphincter , 26 with an internal stent prosthesis , and 15 with traditional external sphincterotomy .  Age and duration of SCI were similar among the three treatment groups . A significant decrease in both voiding pressure and residual urine from presurgery levels persisted during the follow-up period of 3 to 26 months ( mean , 15 months ) in all three groups . Bladder capacity remained constant , renal function improved or stabilized , and autonomic dysreflexia ( AD ) improved in all three groups . Balloon dilatation and prosthesis placement are associated with a significantly shorter length of surgery ( p = 0.045 ) , length of hospitalization ( p = 0.005 ) , decrease in hospitalization cost ( p = 0.01 ) , and decrease in hemoglobin postoperatively ( p = 0.046 ) when compared to external sphincterotomy . Complications of stent insertion included device migration ( three patients ) and secondary bladder neck obstruction ( two patients ) . In the balloon dilatation group , three recurrent sphincter obstructions , one case of bleeding requiring transfusion , and one case of bulbous urethral stricture occurred . After external sphincterotomy , two patients developed recurrent obstruction , two required blood transfusion , and 1 patient noted erectile dysfunction .  Balloon dilatation and prosthesis placement both proved to be as effective as external sphincterotomy in the treatment of DESD . ( ABSTRACT TRUNCATED AT 250 WORDS Abstract Purpose Plants extracts are used in urology to manage urinary tract infections . We aim ed to evaluate the efficacy of a preparation with solidago , orthosiphon , birch and cranberry extracts ( CISTIMEV PLUS ® ) in reducing microbial colonization and biofilm development in patients with indwelling urinary catheters . Methods All consecutive out patients attending our department between January and June 2010 for the substitution of indwelling catheters were considered for this single-blinded , r and omized and controlled pilot study to test superiority of the preventative management ( CISTIMEV PLUS ® , 1 tablet daily for 30 days ) in respect to no treatment . A sample size of 10–40 participants per group was considered adequate . All patients underwent urine culture the same day of the catheter substitution and were then r and omized into test group ( n = 48 ) and control group ( n = 35 ) . Ultrastructural analysis was also performed . After 30 days , the catheter was replaced and the analysis repeated . The primary outcome was the rate of positive urinary culture at the end of the entire study period . Results Ten patients ab and oned the study . At 30 days , according to per- protocol analysis , the groups statistically differed regarding the rate of positive urine cultures : test group 10/43 and control group 16/30 ( p = 0.013 ) ( −30.1 % [ 95 % CI −51.94 to −8.21 ] ) . The most common isolated bacteria were Escherichia coli and Enterococcus faecalis . Conclusions The use of solidago , orthosiphon , birch and cranberry extracts result ed in a significant reduction of microbial colonization in patients with indwelling urinary catheters . Larger clinical trials are needed to demonstrate that the effects here reported are sufficient to reduce symptomatic catheter-associated urinary tract infections 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 g 
    Output:
    
There is currently insufficient evidence to assess the value of different policies for replacing long-term urinary catheters on patient outcomes .