Urology. 2023 Sep 9:S0090-4295(23)00778-1. doi: 10.1016/j.urology.2023.08.031. Online ahead of print.
ABSTRACT
OBJECTIVE: To assess the risk of persistent opioid use following various urologic procedures in adolescents and young adults.
MATERIALS AND METHODS: The TriNetX LLC Diamond Network was queried for patients aged 13 to 21 years who underwent pyeloplasty, hypospadias repair, inguinal hernia repair, inguinal orchiopexy, hydrocelectomy, or circumcision. Cohorts of patients prescribed and not prescribed postoperative opioids were created and propensity-matched for age, race/ethnicity, psychiatric diagnoses, and preoperative pain diagnoses. The primary outcome was new persistent opioid use, defined as new opioid use 3-9 months after index procedure without another surgery requiring anesthesia during the post-operative timeframe.
RESULTS: Of 32,789 patients identified, 66.0% received a postoperative opioid prescription. After propensity score matching for each procedure, 18,416 patients were included: 197 for pyeloplasty, 469 for hypospadias repair, 1,818 for inguinal hernia repair, 2,664 for inguinal orchiectomy, 534 for hydrocelectomy, and 3,526 for circumcision. Overall, 0.41% of patients who did not receive postoperative opioids developed new persistent opioid use, whereas 1.69% of patients who received postoperative opioids developed new persistent opioid use (p<0.05). Patients prescribed postoperative opioids had statistically higher odds of developing new persistent opioid use for hypospadias repair (RR: 17.0; 95% CI: 2.27-127.2), inguinal orchiectomy (RR: 3.46; 95% CI: 1.87-6.4), inguinal hernia repair (RR: 2.18; 95% CI: 1.07-4.44), and circumcision (RR: 4.83; 95% CI: 2.60-8.98).
CONCLUSIONS: The use of postoperative opioids after urological procedures in adolescents and young adults is associated with a significant risk of developing new persistent opioid use.
PMID:37696308 | DOI:10.1016/j.urology.2023.08.031
