Most Men Undergoing Outpatient Urethral Surgery Use No More Than Five Opioid Tablets

Preoperative opioid use was the only predictor of higher postoperative opioid use
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Medically Reviewed By:
Mark Arredondo, M.D.

WEDNESDAY, March 8, 2023 (HealthDay News) -- Among opioid-naive men, five or fewer tablets of opioid medication with a nonopioid care pathway provides satisfactory pain control following outpatient urethral surgery, according to a study published in the March issue of Urology Practice.

Bridget L. Findlay, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues prospectively followed 116 men undergoing outpatient anterior urethroplasty by a single surgeon from August 2017 to January 2021.

The researchers found that one-third of patients did not use opioids postoperatively, and nearly 78 percent of patients used five or fewer tablets. A median of two opioid tablets were used and a median of eight tablets were unused. Preoperative opioid use was the only predictor for use of more than five tablets (75 versus 25 percent). Patients who used tramadol postoperatively reported higher satisfaction and greater percentages of pain reduction (80 versus 50 percent) versus those using oxycodone.

"A multimodal, limited opioid pain management pathway using a small quantity of adjunctive opioid provides adequate pain control after outpatient urethroplasty," the authors write. "The ultimate goal is to optimize multimodal pain pathways and perioperative patient counseling in order to transition to a fully narcotic-free pathway. With the rise in electronic prescribing and close follow-up through patient-provider electronic communications, future studies should be directed toward the impact of these resources on opioid-free pathways."

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