You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Removal of urinary catheters: midnight vs 0600 hours.
Abstract 1:
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


Title 2:
What Time of Day Should a Urethral Catheter be Removed?
Abstract 2:
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


Title 3:
A comparison of midnight versus early morning removal of urinary catheters after transurethral resection of the prostate.
Abstract 3:
PURPOSE This article describes a study that compares the outcomes of midnight versus early morning urethral catheter removal  after transurethral resection of the prostate . SUBJECTS AND SETTING / METHODS : The research setting was a large , metropolitan hospital in Sydney , Australia . Forty-eight patients who had undergone transurethral resection of the prostate were r and omly assigned to either group A , catheter removal at 2400 hours ( n = 20 ) , or group B , catheter removal at 0600 hours ( n = 28 ) . MAIN OUTCOME MEASURES Data collected included time to first void , volume of first void , time between catheter removal and discharge from hospital , weight of prostatic resection , and tissue pathology . RESULTS There was no significant difference between the 2 groups with respect to pathology , weight of prostatic resection , mean volume of first void , or time to first void after catheter removal . There was a significant difference in the time between catheter removal and discharge from hospital . Eighty-five percent of those having catheters removed at 2400 hours were discharged on the same day as catheter removal , as compared with 65 % of those who underwent catheter removal at 0600 hours ( chi 2 = 12.684 ; P < 0.005 ) . CONCLUSION After transurethral resection of the prostate , removal of the urethral catheter at 2400 hours reduced the length of hospital stay , but did not significantly affect the time to first void or the volume of the first void


Title 4:
Systematic removal of catheter 48 hours following transurethral resection and 24 hours following transurethral incision of prostate: a prospective randomized analysis of 213 patients.
Abstract 4:
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


Title 5:
Randomized study of the effect of midnight removal of urinary catheters.
Abstract 5:
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


Title 6:
The infusion trial of micturition.
Abstract 6:
OBJECTIVE To compare three methods for a trial of micturition ( TOM ) ( the midnight removal of the catheter , dawn removal , and a new infusion method ) in a r and omized prospect i ve study . PATIENTS AND METHODS A total of 118 consecutive patients who had undergone transurethral resection of the prostate ( TURP ) or bladder neck incision ( BNI ) underwent TOM by one of the three methods . In the infusion method , the bladder was filled at a fast-drip rate via the catheter from a bag of normal saline connected by an intravenous supply set . The catheter was then removed , the patient voided and the volume was measured . From the volume of saline remaining , it was possible to calculate the residual volume in the patient . RESULTS The infusion TOM took a mean 13 h less than the other two methods , which were statistically indistinguishable . CONCLUSION The infusion TOM is safe and simple , is quick to carry out and can be performed at any time . It establishes the completeness of bladder emptying , which helps in the assessment of voiding


Title 7:
Randomised study of the effect of midnight versus 0600 removal of urinary catheters.
Abstract 7:
A r and omised controlled trial was undertaken to determine the effects of midnight removal of urinary catheters on  patients '  voiding patterns and subsequent discharge from hospital . Patients whose urinary catheters were removed  at midnight showed a greater volume of initial void than those whose catheters  were removed at the usual time of 0600 . Removal of urinary catheters routinely at midnight permits earlier assessment of patients ' voiding , which may allow for earlier discharge from hospital
Based on the limited available evidence , this article suggests benefits in terms of patient outcomes and reduction in the length of hospitalization after midnight removal of the IUCs .