Optimizing recovery An opioid-free pathway for reconstructive urology.

Area of Science:

• Urology
• Pain Management
• Surgical Outcomes

Background:

• Opioid prescriptions for acute postoperative pain can lead to addiction and hinder recovery.
• This study addresses the need for opioid-sparing strategies in reconstructive urologic surgery.

Purpose of the Study:

• To evaluate the feasibility and impact of an opioid-free postoperative pathway.
• To determine if an opioid-free approach affects pain-related patient communication following reconstructive urologic procedures.

Main Methods:

• A case-cohort study compared patients undergoing artificial urinary sphincter (AUS) placement, urethroplasty, or buried penis repair (BPR) before and after 2019.
• Data on demographics, surgical details, and pain-related communications within 60 days were collected via retrospective chart review.
• Statistical analysis used unpaired t-tests and chi-squared tests to compare outcomes between opioid-receiving and opioid-free groups.

Main Results:

• No significant demographic differences were found between the 181 opioid recipients and 179 opioid-free patients.
• Pain-related communication rates were similar between groups (21% opioid vs. 16% opioid-free).
• Only 3.9% of the opioid-free cohort received an opioid postoperatively, and most opioid-treated patients were managed non-narcotically.

Conclusions:

• An opioid-free postoperative regimen for reconstructive urologic surgery is feasible and well-tolerated.
• This approach does not increase pain-related patient communication.
• Findings support the broader adoption of opioid-sparing strategies in surgical care.