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Routine Prescription of Opioids for Post-Vasectomy Pain Control Associated with Persistent Use
David W Barham1, Leah P McMann1, John E Musser1
1Division of Urology, Department of Surgery, Tripler Army Medical Center, Honolulu, Hawaii.
The Journal of Urology
|May 1, 2019
Summary
Routine opioid prescriptions after vasectomy are not necessary and are linked to persistent opioid use. Urologists should limit opioid prescribing post-vasectomy to combat the opioid epidemic.
Area of Science:
- Urology
- Pain Management
- Public Health
Background:
- The American Urological Association (AUA) recommends judicious opioid use.
- Routine opioid prescribing after vasectomy is common but its necessity is questioned.
- The opioid epidemic necessitates a review of prescribing practices.
Purpose of the Study:
- To evaluate the necessity of routine opioid prescriptions for post-vasectomy pain control.
- To determine the association between initial opioid prescription and persistent opioid use.
Main Methods:
- Retrospective chart review of 228 patients undergoing vasectomy (April 2017-March 2018).
- Patients stratified into groups: initially prescribed opioids vs. no opioid prescription.
- Comparison of scrotal pain encounters, subsequent, and new persistent opioid prescriptions.
Main Results:
- No significant difference in scrotal pain encounters between groups (12.7% vs. 18.4%).
- New persistent opioid use was significantly higher in the opioid group (7.8% vs. 1.5%, p=0.046).
Conclusions:
- Opioids are not essential for post-vasectomy pain management.
- Routine opioid prescribing is associated with a higher incidence of persistent opioid use.
- Urologists should limit opioid prescriptions after vasectomy to mitigate risks.
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