Predicting postoperative pain in urology: psychological and social factors matter

To assess postoperative pain levels in patients undergoing urological surgeries and identify factors associated with increased pain.

This prospective single-center study (May 2022-December 2024) included 200 patients who completed the Hospital Anxiety and Depression Scale (HADS) questionnaire preoperatively. Postoperatively, the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) was administered. Predictors of heightened postoperative pain were analyzed using multivariable logistic regression.

All 200 eligible patients participated. The median age was 55 years for males and 52 years for females, with males comprising 70% of participants. Most patients were married (67%) and had at least 12 years of education (89%). A history of anxiety or depression was reported in 16.5% of patients, while 65.5% had prior surgeries. The median preoperative HADS scores were 8 for males and 7 for females (p = 0.1), with abnormal anxiety in 40% of males and 30% of females. Increased HADS scores were significantly associated with higher postoperative pain (B = 0.165, 95% CI: 0.013-0.124, p = 0.016). Being unmarried was also linked to greater postoperative pain (B=-0.175, 95% CI: -1.215- (-0.091), p = 0.023). Other demographic and clinical factors, including age, gender, BMI, education, Charlson comorbidity score, and prior surgeries, were not significant predictors.

Preoperative anxiety is a strong predictor of postoperative pain in urological surgeries, highlighting the need for targeted anxiety management. Marital status also plays a role, while other demographic and clinical variables show limited predictive value.