Postprostatectomy orchitis: reduction in incidence using perioperative ceftriaxone and postoperative ciprofloxacin.

Postoperative orchitis increases the morbidity and overall hospital stay after prostatectomy. A retrospective review of our initial series of 174 cases revealed an incidence of 6% which is similar to other studies. We reviewed our bacterial flora and antibiogram and subsequently started a prospective study combining peri-operative ceftriaxone and postoperative ciprofloxacin, which we compared to our previous series where we used perioperative ceftriaxone followed by postoperative gentamicin and ampicillin. There was an abolition of orchitis as a consequence and a significant reduction in the rate of wound infection. We conclude that a combination of ceftriaxone and ciprofloxacin is efficacious in reducing the rate of infective complications following prostatectomy. We recommend the use of these or similar drugs based on local microbial flora.