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Updated: Aug 30, 2025

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Discharge Opioids are Unnecessary Following Radical Cystectomy.

J M Myrga1, S Wu2, Z G Gul1

  • 1University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA.

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This summary is machine-generated.

Zero-opioid discharge after cystectomy is feasible for both open and robotic approaches. Patients discharged without opioids experienced no increase in follow-up, pain calls, or emergency visits, demonstrating a safe pain management strategy.

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Area of Science:

  • Urology
  • Oncology
  • Pain Management

Background:

  • Radical cystectomy is a major surgery often associated with significant post-operative pain.
  • Opioid analgesics are commonly prescribed after cystectomy, raising concerns about dependence and side effects.
  • Developing opioid-sparing or opioid-free pain management strategies is crucial for improving patient recovery and safety.

Purpose of the Study:

  • To evaluate the feasibility of zero-opioid discharge following radical cystectomy (open and robotic).
  • To assess the impact of zero-opioid discharge on patient-physician office interactions.
  • To identify predictors for requiring opioid prescriptions at discharge.

Main Methods:

  • Retrospective review of 107 patients undergoing open or robotic radical cystectomy.
  • Data abstraction included demographics, perioperative details, and 30-day post-discharge pain-related outcomes.
  • Analysis of variables associated with zero-opioid discharge.

Main Results:

  • 75 out of 107 patients were discharged without opioids.
  • No significant differences were observed in emergency department visits, readmissions, office calls, or pain-related requests between groups.
  • Patient age and surgical pathology were significant predictors of post-operative opioid prescription.

Conclusions:

  • Zero-opioid discharge is a safe and feasible option for patients after radical cystectomy, irrespective of surgical approach.
  • Opioid-sparing protocols do not negatively impact patient follow-up or engagement with the healthcare team.
  • Patient-specific factors like age and pathology should guide opioid prescribing decisions.