We evaluated the prevalence of urinary tract infection (UTI) after
pelvic floor operations for non-malignant etiology and the effectiveness
of antibiotic prophylaxis. This was made possible by a review of the
evidence from relevant randomized controlled trials (RCTs). Nineteen out
of 879 initially identified studies met the criteria for inclusion in
our review. Four RCTs compared an antibiotic prophylactic regimen with
placebo, 11 two different prophylactic antibiotic regimens, and four had
three different treatment arms. Among placebo recipients undergoing
pelvic floor surgery, 10-64% developed UTI. In contrast, UTI after
pelvic floor gynecological surgery occurred in 0-15% of the patients
who received cephalosporins as antibiotic prophylaxis; the likelihood
for postoperative UTI was higher for patients receiving cotrimoxazole
(28%), ampicillin/sulbactam (13.6%), metronidazole plus ampicillin
(20%), metronidazole (10-22.7%), or ciprofloxacin (27.2%). The use of
a cephalosporin as perioperative antimicrobial prophylaxis is the
optimal regimen in preventing UTIs after pelvic floor surgery
