***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: OBJECTIVE To investigate whether early catheter removal  following transurethral prostatectomy ( TURP )  is safe and whether it has any effect on the length of hospital stay . PATIENTS AND METHODS Following transurethral prostatectomy 59 patients were r and omized into one of two groups : those whose catheter was removed on day 1 after surgery and those whose catheter was removed on day 2 . The incidence of complications and the duration of post-operative hospital stay were assessed . RESULTS Catheter removal on day 1 led to a significantly shorter post-operative hospital stay ( 2.3 days versus 3.3 days ) and did not incur a higher incidence of complications . CONCLUSIONS Removal of the catheter on the first day following TURP is safe in selected patients and leads to a shorter post-operative hospital stay In the fields of both nursing and medicine there is a dearth of published literature on the optimum time to remove  indwelling urinary catheters ( IDCs ) following urological surgery .  Tradition seems to be in favour of removing IDCs at 0600 hours despite a lack of evidence to support this practice . This study was undertaken to determine whether midnight removal of IDCs result ed in patients ' resuming normal voiding patterns .  A prospect i ve clinical trial was conducted to determine the impact midnight removal of urinary catheters would have on the patients ' voiding pattern , and subsequent discharge from hospital .  One hundred and sixty patients were entered into the study . The patients were allocated at r and om to have their urinary catheter removed either at midnight or at 0600 hours . Patients who had their catheters removed at midnight passed a greater volume of urine with both their first ( 268 ml compared with 177 ml ; P<0.0001 ) and second voids ( 322 ml compared with 195 ml ; P<0.0001 ) than their counterparts in the 0600 group . This permitted earlier discharge from hospital . The results reported in this study support the findings of earlier research that midnight removal of IDC leads to an earlier resumption of normal voiding patterns , permits earlier discharge from hospital and appears to reduce patients ' anxiety . The recommendation from this study is that there should be a change in hospital policy so that the majority of IDCs are removed at midnight Patients who had undergone bladder neck surgery were r and omized to having their urethral catheters removed either early in the morning or late at night . There was no difference in the incidence of urinary retention between these two groups of patients . However , patients who presented with acute urinary retention had a higher incidence of postoperative urinary retention . This study suggests that a urethral catheter may be safely removed in the evening without increasing the risk of urinary retention . There also seems to be no greater chance of the patient having to be recatheterized at an unsocial hour OBJECTIVE In-dwelling catheters for 24 hours after operation are used routinely in gynecologic surgery . This study assesses whether the immediate removal of an in-dwelling catheter after the operation affects the rate of recatheterization , febrile morbidity , symptomatic urinary tract infections , or subjective pain assessment s. STUDY DESIGN This study was a prospect i ve r and omized controlled trial comprised of 250 women who underwent hysterectomy and who did not require bladder suspension or strict fluid treatment .  The in-dwelling catheter was removed either immediately after the operation or on the first day after the operation . The association between clinical variables and the length of catheterization were assessed by chi-squared analysis . RESULTS Patients were assigned r and omly into 2 groups , with no significant differences in the outcomes , only in the perception of pain . Clinical events included fever ( > /=38.5 degrees C ) that occurred in 6 patients in the in-dwelling catheter group compared with 5 patients in the early removal group ( P=.01 ) , symptomatic urinary tract infections in 3 patients in both groups ( P=.99 ) , and recatheterization in 3 patients in the in-dwelling catheter group compared with 5 patients in the early removal group ( P=.17 ) . Subjectively , patients in the early removal group reported significantly less pain than did the in-dwelling group ( P<.001 ) . CONCLUSION The early removal of in-dwelling catheters after operation was not associated with an increased rate of febrile events , urinary tract infections , or need for recatheterization . In addition , subjective pain assessment was significantly less in the early removal group . Early removal of an in-dwelling catheter immediately after operation is not associated with adverse events OBJECTIVES Postoperative urethral catheter drainage after radical prostatectomy is bothersome to patients . A pilot study was initiated to determine if urethral catheter removal prior to hospital discharge is feasible . METHODS Thirty-three consecutive men undergoing radical retropubic prostatectomy  were prospect ively studied and followed for a minimum of 6 months ( mean , 8.5 ) . Postoperative cystography was utilized to direct early catheter removal . RESULTS Of 33 patients , 27 ( 82 % ) underwent successful catheter removal at a mean of 4.2 postoperative days . No patient experienced urinary retention , urinoma development , pelvic abscess , or anastomotic stricture . Urinary continence is excellent ( no pads required ) in 70 % and good ( stress incontinence requiring 1 to 2 pads/24 hours ) in 18 % of patients at last follow-up . CONCLUSIONS Following radical prostatectomy , early catheter removal prior to hospital discharge is feasible . Early results suggest no deleterious consequences . Prospect i ve monitoring of more patients is needed to determine if this practice is widely applicable The interval before removal of the catheter used in prostatic transurethral surgery  depends to a great extent on the surgeon , with a frequently empirical orientation . We conducted a prospect i ve , r and omized and controlled study of 213 patients who underwent transurethral surgery for benign prostatic hyperplasia . The catheter was removed systematic ally 24 hours after transurethral incision and 48 hours after transurethral resection of the prostate ( group 1 - 52 and 54 patients , respectively ) or the catheterization interval was determined by each surgeon in accordance with the usual criteria ( group 2 - 52 and 55 patients , respectively ) . No statistically significant differences were noted between these 2 groups in regard to complications . We conclude that systematic removal of the catheter at the aforementioned periods is cost-effective , safe and comfortable for the patient A total of 60 patients with acute urinary retention were studied to establish whether a trial without a catheter was justified and to identify subgroups of patients most likely to benefit from this practice . The patients were r and omly allocated to 3 groups ; the catheters were removed either immediately after the bladder was emptied , or 24 or 48 h later ; 17 patients  urinated satisfactorily after removal of the catheter .  Re-establishment of micturition was not associated with the length of history or severity of symptoms of prostatism , with age or the presence of urinary tract infection . The mean retained volume of urine in patients with a satisfactory result was 786 ml and 1069 ml in the failures . Of the 34 patients with retained volumes of less than 900 ml , 15 were successful in re-establishing micturition compared with 2 of 26 of those with retained volumes greater than 900 ml . The time of catheter removal was not important . The 17 successful patients were review ed 6 months later . None reported further urinary retention ; 6 had required prostatectomy for severe symptoms , 6 had minor symptoms and 5 were symptomless . It was concluded that a trial without a catheter is worthwhile , since 11 of 60 patients had not required surgery , but it should be avoided in patients with a residual volume exceeding 900 ml This study shows that removal of urinary catheters at midnight has several advantages over removal at 6 AM . The midnight group had a significantly greater initial voided volume and a longer time to first void than the equivalent 6 AM group . Advantages to midnight catheter removal also exist for nursing staff . Midnight tends to be less busy on the nursing unit compared with 6 AM , thus making it a preferable time for performance of routine tasks . Catheter removal at midnight also allows for convenient observation of patient voiding and assessment earlier in the day . This means that any necessary intervention can take place during working hours when more staff are on duty . There is also the potential for earlier discharge , with economic benefits related to shorter bed stay and more efficient discharge planning . We believe midnight catheter removal offers considerable benefits over the traditional 6 AM time on both general and urology units BACKGROUND Voiding dysfunction is frequently observed after  rectal resection  and justifies urinary drainage . However , there is no agreement about the optimal duration of this postoperative drainage . The aim of this controlled trial was to compare 1 versus 5 days of transurethral catheterization after rectal resection , with special reference to urinary tract infection and bladder retention . METHODS One hundred twenty-six patients undergoing rectal resection  were included in a prospect i ve r and omized study design ed to compare the results for patients undergoing 1 day of transurethral catheterization after rectal resection  ( 1-day group ) with those for patients undergoing 5 days ' catheterization  ( 5-day group ) . RESULTS Patients were r and omly assigned to the 1-day and 5-day groups ( n = 64 and 62 , respectively ) . Clinical findings and surgical procedures were comparable in both groups . Acute urinary retention occurred in 16 patients ( 25 % ) in the 1-day group versus 6 ( 10 % ) in the 5-day group ( P < .05 ) . Urinary tract infection was observed in 13 of 64 patients ( 20 % ) in the 1-day group versus 26 of 62 ( 42 % ) in the 5-day group ( P < .01 ) . Multivariate analysis revealed that after 1 day of catheterization carcinoma of the low rectum and lymph node metastasis were significant risk factors for acute urinary retention ( P < .05 for both factors ) . After selection of patients without low rectum carcinoma , the acute urinary retention rate was comparable in both groups ( 14 % in the 1-day group versus 7 % in the 5-day group ) , but the urinary tract infection rate was significantly lower in the 1-day group versus the 5-day group ( 14 % vs 40 , P < .01 ) . CONCLUSIONS Our controlled study showed that after rectal resection 1 day of urinary drainage can be recommended for most patients . Five-day drainage should be reserved for patients with low rectal carcinoma OBJECTIVES Shortening hospital stay yet not compromising quality of care can result in significant cost savings for children undergoing surgical correction of vesicoureteral reflux . METHODS We review ed the medical records of pediatric patients who underwent ureteroneocystostomy between July 1995 and July 1997 . A total of 43 patients , aged 0.2 to 18 years ( mean 5.2 ) who all received identical postoperative care , except for their pain management and the time of bladder catheter removal , were included in the study . Twenty-three were treated with intravenous ketorolac tromethamine ( Toradol ) ; the remaining 20 received narcotics in the immediate postoperative period . The bladder catheter was removed in less than 24 hours in 22 children , and greater than 24 hours in 21 . RESULTS Patients who received ketorolac tromethamine for postoperative analgesia had on average shorter hospital length of stays than those treated with narcotics ( 1.4 versus 2.5 days , respectively ; P < 0.001 ) . The average stay for children whose bladder catheter was removed within 24 hours postoperatively was significantly shorter than those whose catheter was removed after a 24-hour period ( 1.4 versus 2.4 days , respectively ; P < 0.001 ) . There were no reimplantation failures . One child presented 2 days postoperatively with anemia , which did not require transfusion . CONCLUSIONS Our review demonstrates that ketorolac tromethamine can be used safely and effectively in children for immediate postoperative analgesia , and that its proper use combined with early catheter removal can reduce the length of hospital stay for pediatric patients undergoing ureteroneocystostomy PURPOSE We prospect ively tested the safety of routine removal of the catheter as early as 2 to 4 days after laparoscopic radical prostatectomy . MATERIAL S AND METHODS Between March 1998 and March 2001 , 228 patients underwent laparoscopic radical prostatectomy for clinical ly organ confined prostate cancer . The last 113 consecutive patients were included in a prospect i ve study according to gravitational cystography performed 2 to 4 days postoperatively . If no leak was seen the catheter was removed . If a leak was apparent the catheter was left indwelling for another 6 days and cystography was repeated . RESULTS Cystography 2 to 4 days postoperatively showed an anastomosis without a leak in 96 ( 84.9 % ) patients who subsequently had the catheters removed . There were 28 patients who had the catheter removed on postoperative day 2 , 28 day 3 and 40 day 4 . In 17 ( 15.1 % ) patients an anastomotic leak was observed , and the catheter was not removed at that time . Of the 96 patients in whom the catheter was removed early 10 ( 10.4 % ) had urinary retention that 
    Output:
    
In 11 RCTs amongst 1389 people , there was no significant difference in need for recatheterisation , although recatheterisation after removal at night was more likely to be during working hours .
AUTHORS ' CONCLUSIONS There is suggestive but inconclusive evidence of a benefit from midnight removal of the indwelling urethral catheter .
The evidence also suggests shorter hospital stay after early rather than delayed catheter removal but the effects on other outcomes are unclear .
There is little evidence on which to judge other aspects of management , such as catheter clamping