Bowel preparation before radical cystectomy

  • Şakir Ongün
  • Güven Aslan

Bull Urooncol 2012;11(1):62-65

Complications as a result of bacterial contamination are major challenges in reconstructive surgeries on bowel segments. Since 1977, most institutions used similar regimens of 3-day mechanical bowel preperation method accompanied by oral antibiotic prophylaxis for urologic surgeries. The disadvantages of 3-day mechanical bowel preperation method, including patient exhaustion, patient inconvenience, long hospitalization, and potential nutritional imbalance have encouraged surgeons to reconsider bowel preperation protocols. Conventional rigid bowel preperation protocols have nowadays been replaced by less uncomfortable methods of bowel preperation. On the other hand, few retrospective and nonrandomized trials have shown no additional protective effect of mechanical bowel preperation in radical cystectomy, in the presence of an adequate systemic antibiotic prophylaxis. However the results of these studies were not convincing among urologists to put in their daily practice because the lack of data in terms of evidenced base medicine. Today it is strongly recomended that a short form of bowel preparation either with oral laxatives or enema should be applied to patients before surgery.

Keywords: radical cystectomy; urinary diversion; bowel preperation