Prevention and Treatment of Urinary Tract Infections After Radical Cystectomy, Diversion, and Reservoirs

Radical cystectomy with urinary diversion has a high rate of early and late complications. Infections after surgery are extremely common, especially in patients with preoperative and intraoperative established risk factors. The type of diversion performed can influence the dynamics of urinary tract infections (UTIs) onset, although other postoperative risk factors such as urethral strictures may contribute to improve the rate of infection. The most common bacteria that cause UTI are E. coli, but a dangerous infection is promoted by C. difficile also due to a wrong antimicrobial prophylaxis. Surgeons must follow the guidelines to reduce the rate of perioperative infection. The treatment of bacteriuria in the absence of risk factors is controversial, while in case of UTI and sepsis, the patient must be treated and all risk factors must be investigated and resolved.