Urinary tract infection after radical cystectomy: a vexing problem despite prophylactic antibiotics

Radical cystectomy (RC) with pelvic lymph node dissection, preceded by cisplatin-based neoadjuvant chemotherapy in appropriate patients, remains the standard treatment of muscle invasive bladder cancer (1). Despite improvement in perioperative care pathways with an associated trend towards lower mortality, RC remains a complex and often morbid operation with significant risk to patients (2). Early infectious complication rates after RC and urinary diversion based on several large contemporary institutional cohorts ranges from 7–30% and is a significant concern post-procedure (3).