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Informed Consent and Perioperative Antibiotics

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Book cover Ureteroscopy

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

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.

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Author information

Authors and Affiliations

  1. Endourology Division, Urology Department, University of Michigan, Ann Arbor, MI, USA

    Christopher L. Allam D.O.

  2. Division of Endourology and Stone Disease, Department of Urology, University of Michigan Health System, 1500 East Medical Center Drive, TC 3875, Ann Arbor, MI, 48109-5330, USA

    J. Stuart Wolf Jr. M.D.

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  1. Christopher L. Allam D.O.
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  2. J. Stuart Wolf Jr. M.D.
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Correspondence to J. Stuart Wolf Jr. M.D. .

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Editors and Affiliations

  1. Glickman Urological & Kidney Institute, Department of Urology, The Cleveland Clinic, 2842 Fontenay Road, Cleveland, 44120, Ohio, USA

    Manoj Monga

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Allam, C.L., Wolf, J.S. (2013). Informed Consent and Perioperative Antibiotics. In: Monga, M. (eds) Ureteroscopy. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-206-3_18

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  • DOI: https://doi.org/10.1007/978-1-62703-206-3_18

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-205-6

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