Analysis of main positions of the antibacterial prophylaxis methods before surgical interventions and main requirements for antibacterial prophylaxis medications. Approaches to empirical antibiotic prophylaxis in surgeries on kidneys, ureters, bladder, prostate, scrotum organs, as well as reconstructive interventions using a fragment of intestine are stated. Separate review of antibacterial prophylaxis in surgical interventions on blood vessels of genitourinary system, implantation of penile, testicular prosthesis' and artificial bladder sphincter, and surgical treatment of injuries of the urogenital tract. Possible infectious-inflammatory complications of most frequently performed surgeries in urological practice and ways of their prevention are analyzed in details. We reviewed the selection of antibacterial agents, depending on the patient's diagnosis, previously applied antimicrobial agents and the type of surgical intervention. All proposed schemes are optimized in three areas: clinical effectiveness, economic feasibility, the epidemiological safety (prevention of multidrug- resistant strains of microorganisms breeding). Particular attention is paid to the choice of drug for empirical antibiotic prophylaxis in patients with severe comorbidities, affecting the pharmacokinetics of drugs and reducing the immunological reactivity of the body – kidney failure and HIV infection.