***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: In this r and omized prospect i ve trial urethral and suprapubic routes were compared in terms of tolerance and infectious potential . Daily bacteriuria determined infectious danger and patients were interrogated on the pain and discomfort induced by their catheter every day . Identical single dose pre-operative antibiotic prophylaxis was routinely applied . Patients ( n = 50 ) were divided into two similar groups ( 25 suprapubic catheters and 25 urethral catheters )  . Four patients in the suprapubic group were excluded . All specimen cultured by suprapubic catheter remained sterile . Nine patients with urethral catheterization eventually developed bacteriuria . The difference became significant on the third day of catheterization ( p < 0.05 ) and increased on days 4 and 5 ( p < 0.01 ) . Between the two groups , pain and discomfort did not achieve statistical significance . Suprapubic catheterization is preferable to the alternative using the urethral route in terms of improving urine sterility A total of 515 patients with spinal cord injuries were admitted to the Conradie Hospital 's Spinal Cord Injuries Centre during a 3-year period from September 1974 to September 1977 .  Intermittent catheterization was used for urinary drainage in all patients with incomplete lesions as initially assessed neurologically , and indwelling catheterization in those with complete lesions . Transcutaneous suprapubic Bonnano ( stab ) continuous catheter drainage was used in a r and om group of 24 male patients with complete neurological lesions . The majority of the patients were admitted within 24 hours of injury . The follow-up period varied from 1 to 4 years . At 3 months more than 50 % of patients had a balanced neurogenic bladder and were catheter-free . At 12 months 19 % of patients were still catheter-dependent for reasons explained . Bladder outlet operations were more frequent among patients with thoracic lesions and were indicated 3 times more often in patients with complete neurological lesions . Bladder outlet operations were performed on 8.6 % of patients . Only 5 patients ( 1 % ) required permanent urinary diversion . A urodynamic work-up is no longer regarded as merely a research tool in the investigation of patients with neurogenic bladder dysfunction . Both urodynamic and videoradiological techniques are a prerequisite to proper management of the neurogenic urinary tract Objective A stratified , r and omised , waitlist controlled study over 12 months assessed the effectiveness of a 6 week bladder rehabilitation programme in persons with multiple sclerosis ( pwMS ) in an Australian community cohort . Methods Patients with definite MS and bladder issues ( n=74 ) recruited from a tertiary hospital data base were r and omised to a treatment group ( n=40 ) for an individualised bladder rehabilitation programme or to a control waitlist group ( n=34 ) . The Urogenital Distress Inventory ( UDI6 ) , Neurological Disability Scale ( NDS ) and the American Urological Association Symptom Index ( AUA ) assessed bladder impairment and ‘ activity limitation ’ ; a single Quality of life ( QoL ) item in the AUA and the Incontinence Impact Question naire ( IIQ7 ) measured restriction in ‘ participation ’ . Primary outcome measures were assessed at baseline and at 12 months . Results Analysis of per protocol data from 58 patients ( treatment n=24 , control n=34 ) showed reduced disability in the treatment group , with significant differences ( p<0.001 ) and large effect sizes ( > 0.5 ) in post-treatment UDI6 , NDS , AUA total , AUA QoL and IIQ7 scores for the two groups . The treatment group compared with the control group showed improvement : 78 % versus 27 % for UDI6 and 59 % versus 17 % improved for IIQ7 . More patients in the control group deteriorated over the study period on the UDI6 ( 30 % vs 0 % ; p<0.001 ) and IIQ7 ( 39 vs 0 % ; p=0.001 ) . Conclusion A multifaceted , individualised bladder rehabilitation programme reduces disability and improves QoL in pwMS compared with no intervention after 12 months of follow-up . Information on specific interventions in different bladder types in MS and the impact on QoL need further evaluation . Australian Clinical trials Registry ACTRNO12605000676617 75 patients , needing a bladder drainage for nonurological indications and having sterile urines were studied after r and omization into two groups . In the first group , drained with an urethral catheter , urinary infection took place in 12 (= 30 % ) patients , while it was detected in 4 (= 11 % ) drained with a suprapubic catheter . In this latter group , patients felt more comfortable , had less pain ; the duration of urinary drainage and hospital stay was shorter A prospect i ve trial , comparing fine-bore suprapubic cathetisation and intermittent urethral catheterisation as methods of bladder drainage in the acute stage following spinal cord injury , was conducted . The results showed no important difference in either method of bladder management . Fine-bore suprapubic catheterisation is particularly suitable for young female patients , who find  repeated urethral catheterisation  distasteful ; in other patients it is an acceptable alternative to intermittent urethral catheterisation , particularly where economic considerations are paramount OBJECTIVE To compare the complications especially infection in two groups ; group-A : those performing clean intermittent self-catheterization ( CISC )  and group-B : patients with indwelling catheters .  METHODS Comparative study , conducted at Department of Urology , Jinnah Postgraduate Medical Centre , Karachi . A total of 80 patients with ages between 15 - 80 years were studied . There were 40 patients in each group comprising of 35 males and 5 females in group-A and 38 males and 2 females in group-B. Group-A patients were mainly those with neurogenic bladder ( n = 25 ) and postoperative cases of stricture . While in indwelling group 35 patients had neurogenic bladder with the remaining ( n = 5 ) having benign prostatic hypertrophy . Group-A performed CISC 1 - 4 times/24 hours depending on the primary disease while in group-B fortnightly catheter change was done under aseptic conditions . Symptomatic infections were taken into consideration in both the groups proven by urine C/S. RESULTS Symptomatic infections as pyelonephritis , epididymorchitis and urosepsis occurred in both groups . In group-A 2 ( 5 % ) patients developed pyelonephritis as compared to 10 ( 25 % ) in group-B ( P value 0.01 ) . Epididymorchitis and urosepsis occurred in 1 ( 2.5 % ) and 0 patients in group-A while 3 ( 7 % ) and 2 ( 5 % ) patients in group-B. Statistically significant infection ( pyelonephritis ) occurred in group-B. CONCLUSION CISC is much safer practice with less complications and infection rate than indwelling catheters Sixty‐six patients requiring catheterization in the course of general surgical operations were r and omly allocated into two groups . Of the 34 patients  catheterized urethrally 16 developed urinary tract infections whereas of the 32 suprapubically catheterized patients only 2 developed an infection ( P<0.001 ) . Five patients required  recatheterization  after removal of their urethral catheters . There were no major complications associated with the use of suprapubic catheters . We propose that , when catheterization is required during a general surgical procedure , the suprapubic route is to be preferred 
    Output:
    
It was not possible to draw any conclusions regarding the use of different types of catheter in managing the neurogenic bladder