Prolapse Surgery: What Kind of Antibiotic Prophylaxis Is Necessary?

Urol Int. 2021;105(9-10):771-776. doi: 10.1159/000517788. Epub 2021 Jul 30.

Abstract

Introduction: The aim of this study was to assess whether antibiotic prophylaxis or therapy is sufficient for laparoscopic or vaginal prolapse surgery with mesh.

Methods: This is a single-center prospective study. The study was divided into 3 groups. Protocol A: metronidazole (15 mg/kg) and piperacillin-tazobactam (2 g) 1 h before surgery and, for postoperative treatment, gentamycin (160 mg) 1 h before surgery in a single dose. Metronidazole and piperacillin-tazobactam were administered until hospital discharge. Protocol B: gentamycin and piperacillin-tazobactam in the same manner as group A. Protocol C: clindamycin (600 mg) and gentamicin (160 mg) 1 h before surgery in a single dose.

Results: We included 87 consecutive patients who underwent prolapse surgery involving mesh prostheses: 57 by the laparoscopic approach and 30 by the vaginal route. Of these, 30 patients were included in protocol A, 30 in protocol B, and 27 in protocol C. There were no statistically significant differences among the 3 protocols regarding any postoperative complications, except for urinary tract infections that were more in the vaginal approach than in the laparoscopic route, in protocol A (p = 0.002).

Conclusions: One-shot prophylaxis can be successfully used in prolapse surgery regardless of the surgical approach.

Keywords: Antibiotic prophylaxis; Complication surgery; Infection mesh; Laparoscopic sacrocolpopexy; Prolapse surgery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Antibiotic Prophylaxis* / adverse effects
  • Drug Administration Schedule
  • Female
  • Gentamicins / administration & dosage*
  • Gentamicins / adverse effects
  • Gynecologic Surgical Procedures* / adverse effects
  • Gynecologic Surgical Procedures* / instrumentation
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / instrumentation
  • Metronidazole / administration & dosage*
  • Metronidazole / adverse effects
  • Middle Aged
  • Pelvic Organ Prolapse / surgery*
  • Piperacillin, Tazobactam Drug Combination / administration & dosage*
  • Piperacillin, Tazobactam Drug Combination / adverse effects
  • Prospective Studies
  • Surgical Mesh
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*
  • Time Factors
  • Treatment Outcome
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / prevention & control*

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Metronidazole
  • Piperacillin, Tazobactam Drug Combination