Opioid prescriptions for minor urologic surgeries up risk for persistent use

Men who are prescribed opioids for minor urologic surgeries are more likely to develop persistent long-term opioid use, a recent study has found.

Researchers retrospectively assessed 91,083 men who underwent minor urological procedure, such as vasectomy, urethrotomy, circumcision or spermatocelectomy. The primary outcome was persistent opioid use, defined as the filling of a prescription 9–15 months after the surgery. Admission for opioid overdose was set as a secondary outcome.

More than a third of the participants (35 percent; n=32,174; median age, 39.0 years) filled an opioid prescription within 5 days of the index procedure; majority (96 percent) were claimed on the first day. Immediate-release codeine (70 percent) was the predominant medication, followed by oxycodone (14 percent) and tramadol (13 percent).

Logistic regression analysis found that those who took opioid medication after the procedure were significantly more likely to be at risk of persistent opioid use even a year after the operation (adjusted odds ratio [OR], 1.43, 95 percent confidence interval [CI], 1.26–1.62; p<0.001). These men repeatedly filled opioid prescriptions 9–15 months after the index procedure.

Moreover, the risk for emergency department visits or hospital admissions for opioid overdose was significantly elevated in these participants (OR, 3.01, 95 percent CI, 1.55–5.85; p<0.001). The principal findings were robust across sensitivity analyses.

“The number needed to harm with postprocedure opioids is concerning. For every 148 men who received a postprocedure opioid prescription, one had evidence of new persistent opioid use a year later,” the researchers pointed out.