Ureteroscopy pp 209-216 | Cite as

Informed Consent and Perioperative Antibiotics

  • Christopher L. Allam
  • J. Stuart WolfJr.Email author
Part of the Current Clinical Urology book series (CCU)


Preoperative preparation for ureteroscopy includes, among other activities, obtaining informed consent and deciding on the use of antimicrobial prophylaxis. Informed consent is essentially the concept that individuals have the right to make decisions affecting their bodies and health. Informed consent must include (1) the inherent and potential hazards of the proposed treatment, (2) the alternatives to the treatment, if any, and (3) the results likely if the patient remains untreated. In the event of litigation regarding informed consent, a plaintiff has a two-part burden. First, it must be proven the physician did not meet the required standard for informed consents. Second, the plaintiff must prove a causal relationship between the physician’s failure to disclose information and a direct damage to the patient.

In general, antimicrobial prophylaxis has been shown to reduce the incidence of surgical wound infection, and as such is recommended for most operations. In the setting of ureteroscopy, the “surgical wound infection” is postoperative urinary tract infection. Based upon evidence from randomized controlled trials, American Urological Association recommends antimicrobial prophylaxis for all ureteroscopies, although some other organizations recommend differently. Published recommendations, in addition to hospital antibiotic policies and local drug resistant patterns, aid in the selection of a specific antimicrobial prophylaxis program. Recommended agents for antimicrobial prophylaxis in association with ureteroscopy include fluoroquinolone, trimethoprim–sulfamethoxazole, aminoglycoside ± ampicillin, first/second generation cephalosporin, or amoxicillin/clavulanate. Duration of prophylaxis should be 24 h or less.


Surgical Site Infection Infective Endocarditis Antimicrobial Prophylaxis Stent Removal Surgical Wound Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Endourology Division, Urology DepartmentUniversity of MichiganAnn ArborUSA
  2. 2.Division of Endourology and Stone Disease, Department of UrologyUniversity of Michigan Health SystemAnn ArborUSA

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