Preoperative preparation of the bowel for urological surgery: a review

The risk of postoperative complications following opening of the intestine can be reduced by lowering the intraluminal bacterial count. The latter is achieved principally by decreasing the mass of the gut content and by antibiotic prophylaxis. Macroscopically satisfactory decontamination of the gut can be attained with laxatives, enemas, elementary diet or orthograde lavage. We prefer oral lavage with Golytely solution since it allows rapid preparation of the gut and is well tolerated. The value of antibiotic prophylaxis in association with operations on the colon or rectum is undisputed and a number of regimes have been shown to be effective. In view of its effectiveness and lack of side effects. 24-hour perioperative parenteral prophylaxis with metronidazole can be recommended.