***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: AIMS Routine catheterization following vaginal prolapse surgery has advantages like prevention of postoperative retention of urine and prevention of any adverse effect on surgical outcome . However , it increases the risk of urinary tract infection ( UTI ) , prevent early ambulation and prolong hospital stay . This r and omized controlled trial was done on how best to minimize catheter related complication after prolapse surgery . METHODS 200 patients planned for vaginal prolapse surgery were recruited and r and omized into two groups . In group I and group II catheter was removed on 1(st ) and 4(th ) post operative day , respectively . After removal , if patient could not void or when residual urine volume exceeds 150 mL , recatheterisation was done for another three days . Sample of urine was sent for culture during catheter removal . RESULTS Age , parity , type of surgery and mean operation time did not differ significantly between the two groups . Mean duration of catheterization  was significantly shorter ( 1.64 vs 4.09 ) and mean duration of hospital stay was shorter by 1.2 days , in first group . However a significantly higher number of retention of urine or residual urine more than 150 mL was found in the early removal group ( OR 3.10 ) but lesser chance of development of urinary tract infection ( OR 0.10 ) . CONCLUSIONS The early removal of catheter seems more advantageous , with lower incidence of urinary tract infection and a shorter hospital stay although associated with an increased risk of recatheterisation OBJECTIVE It is unclear if any catheterisation is necessary after vaginal surgery for pelvic organ prolapse . The aim of this study was to determine if indwelling catheterisation is necessary after these procedures . STUDY DESIGN A r and omised controlled trial of immediate post-operative removal of catheter compared to a suprapubic catheter ( SPC )  after vaginal prolapse surgery . In the Suprapubic group the catheter was left on free drainage until a voiding trial was commenced at 48h . Women in the immediate removal group underwent in/out catheterisation only if they had not voided by 8h after surgery to ensure the bladder did not over-distend . RESULTS 55 % ( n=17 ) of patients in the immediate removal group did not require catheterisation postoperatively . A further 13 ( 42 % ) patients only required one in/out catheterisation 8h post operatively . In the immediate removal group duration of catheterisation was significantly shorter ( median 0h , IQR 0 - 8h , range 0 - 16h ) vs ( 6days ( IQR 2 - 8days , range 2 - 19h ) p=0.001 ) . The duration of hospital stay ( 7days ( range 3 - 16 ) vs. 9 ( range 3 - 27 ) p=0.014 ) , day of first mobilisation ( Day 1 , range 0 - 2 , vs. Day 2 , range 1 - 4 , p=0.001 ) , and rate of Symptomatic bacturia ( 16 % vs. 52 % , p<0.01 ) were all significantly better with immediate catheter removal . CONCLUSIONS After vaginal surgery for pelvic organ prolapse , the majority of patients do not require extended catheterisation . Early removal of a catheter reduces urinary tract infection and significantly decreases hospital stay . Such a policy should result in improved patient satisfaction and reduced hospital costs Introduction and hypothesisThe purpose was to determine if pre-operative guided imagery ( GIM ) would help women to feel more prepared , less anxious , and have higher satisfaction scores 6 weeks after surgery compared with routine care . Methods Eligible women planning to undergo pelvic floor surgery were enrolled and r and omized . The GIM group received an institution-specific CD that uses GIM to detail day of surgery ( DOS ) events and expectations . Participants were asked to listen to the CD once daily during the week before surgery . At three time points ( surgical consent visit , DOS , and 6-weeks post-operatively ) , we measured anxiety using the State and Trait Anxiety Inventory for Adults ( STADI ) , in addition to preparedness for surgery and overall satisfaction ( ten-point Likert scales ) . Data were analyzed in SPSS 23 using two-tailed t tests . Results A total of 38 out of 44 ( 86 % ) enrolled participants completed the study ( GIM : 18 , control : 20 ) . The  GIM self-reported compliance rate was 72 % , with an average use of 4.8 times ( range = 3–8 times ) . Women in the GIM group reported a significant increase from baseline in preparedness for surgery on both DOS and 6 weeks post-operatively ( 7.32 ± 1.81 vs 9.11 ± 1.13 , p = 0.001 ) and ( 7.32 ± 1.81 vs 9.22 ± 0.81 , p = 0.001 ) respectively ; a change that was not seen in the control group . Satisfaction was high in both the GIM and the control group ( 9.55 ± 0.85 and 9.05 ± 1.70 , p = 0.263 ) . In all patients , anxiety increased from baseline to DOS and dropped at 6 weeks post-operatively , and was not significantly different in the two groups . Conclusions Guided imagery improved patient preparedness for pelvic floor surgery with an overnight stay on their DOS and 6 weeks post-operatively Introduction and hypothesisThe aim of this study was to compare the number of temporary catheter replacements and urinary tract infections after  indwelling catheterization  for 2 versus 5 days following an anterior colporrhaphy . Methods Two hundred forty-six patients were r and omly assigned to 2 or 5 days of indwelling catheterization .  Outcome measures were temporary catheter replacements because of post-voiding residual > 200 mL after removal of the indwelling catheter , urinary tract infections , and hospital stay . All patients were analyzed according to the intention to treat principle . Results Compared to the 5-day protocol group , in the 2-day protocol group more patients needed temporary catheter replacement ( 9 % versus 28 % , odds ratio ( OR ) 4.0 , confidence interval ( CI ) 1.9–8.3 , p < 0.01 ) , whereas less patients had a urinary tract infection ( 37 % versus 22 % , OR 0.5 , CI 0.3–0.9 , p = 0.02 ) and median hospital stay was lower . Conclusions Removal of an indwelling catheter after 2 versus 5 days following anterior colporrhaphy is associated with more temporary catheter replacements , but less urinary tract infections and a shorter hospital stay Introduction and hypothesisThere is evidence that in nonsurgical population s , pelvic floor muscle training ( PFMT ) and lifestyle advice improves symptoms and stage of pelvic organ prolapse ( POP ) . Some women , however , require surgery , after which de novo symptoms can develop or additional surgery is required due to recurrence . Robust evidence is required as to the benefit of perioperative PFMT in the postsurgery reduction of symptoms and POP recurrence . The aim of this study was to assess the feasibility of and collect pilot data to inform sample size ( SS ) calculation for a multicentre r and omised controlled trial ( RCT ) of perioperative PFMT following surgical intervention for POP . Methods Fifty-seven participants were recruited and r and omised to a treatment group ( one pre and six postoperative PFMT sessions ) or a control group ( usual care ) . The primary outcome measure was the Pelvic Organ Prolapse Symptom Score ( POP-SS ) at 12 months ; secondary outcome measures included measurement of prolapse , the pelvic floor and question naires relating to urinary and bowel incontinence . All outcomes were measured at 0 , 6 and 12 months . Results Information on recruitment , retention and appropriateness of outcome measures for a definitive trial was gathered , and data enabled us to undertake an SS calculation . When compared with the control group ( n = 29 ) , benefits to the intervention group ( n = 28 ) were observed in terms of fewer prolapse symptoms at 12 months [ mean difference 3.94 ; 95 % confidence interval ( CI ) 1.35–6.75 ; t = 3.24 , p = 0.006 ] ; however , these results must be viewed with caution due to possible selection bias . Conclusion With modifications to design identified in this pilot study , a multicentre RCT is feasible Objective To evaluate the use and effect of early administration of vaginal estrogen via a continuous low-dose estradiol vaginal ring placed immediately after pelvic reconstructive surgery . Methods This was a r and omized controlled trial of 65 postmenopausal women undergoing vaginal reconstructive surgery . The subjects were r and omly assigned to receive an estradiol-releasing vaginal ring , placebo vaginal ring , or control without vaginal ring for 12 weeks immediately after vaginal reconstructive surgery . The primary outcome was tissue quality based on vaginal maturation 3 months postoperatively . Secondary outcome measures were subjective and objective signs of atrophy ; vaginal pH ; the presence of granulation tissue , microscopic inflammation , and major healing abnormalities ; and the ability to tolerate an intravaginal ring . Results At 12 weeks , the estradiol ring group had a significantly improved maturation value ( P<0.01 ) and objective atrophy assessment ( P<0.01 ) compared with the placebo ring and control arms . Granulation tissue was increased in the placebo ring arm ( P<0.01 ) . Subjective atrophy scores did not differ among the groups ( P=0.39 ) . Conclusions Early administration of vaginal estrogen after vaginal surgery via an estradiol-releasing ring is feasible and results in improved markers of tissue quality postoperatively compared to placebo and controls OBJECTIVE : To compare surgeons ' intraoperative surgeon acceptability or assessment of the operative field regarding bowel contents and patients ' satisfaction with or without a mechanical bowel preparation before reconstructive vaginal prolapse surgery . METHODS : In this single-blind , r and omized trial , women scheduled to undergo vaginal prolapse surgery with a planned apical suspension and posterior colporrhaphy were allocated using block r and omization to an intervention or control group . Surgeons were blinded to patient allocation . One day before surgery , mechanical bowel preparation instructions consisted of a clear liquid diet and two self-administered saline enemas ; the participants in the control group sustained a regular diet and nothing by mouth after midnight . The primary outcome was surgeons ' intraoperative assessment of the surgical field regarding bowel content as measured on a 4-point Likert scale ( 1 , excellent ; 4 , poor ) . Secondary outcomes included participant satisfaction and bowel symptoms . The primary outcome was determined by intention-to-treat analysis and other analyses were per protocol . RESULTS : Of the 150 women r and omized ( 75 women to intervention and control group ) , 145 completed the study . No differences existed in the demographic , clinical , and intraoperative characteristics between groups ( P>.05 ) . Surgeons ' intraoperative assessment rating was 85 % “ excellent or good ” with bowel preparation compared with 90 % for participants in the control group ( odds ratio [ OR ] 0.59 , 95 % confidence interval [ CI ] 0.21–1.61 ; P=.30 ) . The bowel preparation group was less likely to report “ complete ” satisfaction compared with the participants in the control group ( OR 0.11 , 95 % CI 0.04–0.35 ; P<.001 ) . Abdominal fullness and cramping , fatigue , anal irritation , and hunger pains were greater in the bowel preparation group ( all P<.01 ) . CONCLUSION : Before reconstructive vaginal surgery , mechanical bowel preparation conferred no benefit regarding surgeons ' intraoperative assessment of the operative field , reflected decreased patient satisfaction , and had increased abdominal symptoms . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT01431040 . LEVEL OF EVIDENCE : Introduction and hypothesisHydrodissection incorporating different types of vasoconstrictors is commonly used in vaginal prolapse surgery . There is little evidence as to whether it adds clinical value or whether it exposes the patient to unnecessary risk . The aim of this study was to compare the effect of a vasoconstrictor compared with saline alone on operative blood loss and cardiovascular parameters in a r and omised clinical trial setting . Methods Patients undergoing vaginal prolapse surgery were r and omised to an ornipressin ( Por-8 , Ferring ) solution or saline alone for hydrodissection . The surgeon and patient were blinded to the solution used . Operative blood loss was accurately quantified and blood pressure and pulse readings recorded Pre , intra- and postoperatively . Results Eighty women were r and omised . There was a statistically significant difference in the median blood loss : 35 ml ( 1 - 209 ml ) in the ornipressin group compared with 81 ml ( 2 - 328 ml ) in the saline group , p = 0.03 . There was no statistically significant difference in the median pre and postoperative blood pressure or pulse rate between groups . Conclusions The use of a vasoconstrictor ( ornipressin ) result ed in a statistically significant decrease in operative blood loss during vaginal prolapse surgery . This occurred without any significant changes in measured cardiovascular parameters INTRODUCTION This assessor-blinded r and omized controlled trial investigated the effect of a pre- and post-operative physiotherapy-supervised pelvic floor muscle ( PFM ) training program in women 
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With regard to other interventions ( preoperative bowel preparation and injection of vasoconstrictor agent , ureteral stent placement during uterosacral ligament suspension , postoperative vaginal pack insertion , use of vaginal dilators , prophylactic antibiotics for postoperative catheter care ) , we found no evidence regarding rates of recurrent prolapse and no clear evidence that these interventions were associated with clinical ly meaningful reductions in adverse effects , such as intraoperative or postoperative blood transfusion , intraoperative ureteral injury , or postoperative urinary tract infection