Opioid prescribing patterns following surgical interventions for benign prostatic hyperplasia

Authors

  • Laura E. Gressler University of Arkansas for Medical Sciences
  • Christina Sze Weill Cornell Medicine
  • Ananth Punyala Weill Cornell Medicine
  • Susana Martinez-Diaz Weill Cornell Medicine
  • Naeem Bhojani Universite de Montreal
  • Kevin C. Zorn BPH Canada Prostate Surgery Institute
  • Dean Elterman University of Toronto
  • Bilal Chughtai Smith Institute for Urology at Northwell Health

DOI:

https://doi.org/10.5489/cuaj.8958

Keywords:

benign prostatic hyperplasia, bias analysis, long-term opioid use, pharmacoepidemiology, post-operative opioid prescribing

Abstract

INTRODUCTION: This study aimed to analyze opioid prescribing behavior following surgical interventions for benign prostatic hyperplasia (BPH), focusing on differences in postoperative opioid prescribing practices between patients who undergo surgical procedures in operative room (OR) settings vs. non-operative room (non-OR) settings.

METHODS: A retrospective cohort study was conducted using a 10% random sample of the IQVIA PharMetrics® Plus for Academics database, including men who underwent surgical interventions for BPH from 2015–2020. Propensity score analysis and inverse probability treatment weighting were employed to adjust for potential confounders. Primary outcomes included opioid receipt, cumulative days of opioid use, and morphine equivalent daily dose (MEDD).

RESULTS: Among the included men (n=6022), those undergoing procedures in OR settings were more likely to receive opioid prescriptions postoperatively compared to those in non-OR settings (42.78% vs. 28.00%, p<0.001). While cumulative days and MEDD of opioid prescriptions did not significantly differ between groups, there was a statistically significant difference in the distribution of opioid receipt duration (p=0.0128). The adjusted model showed significantly higher odds of opioid prescription for men undergoing OR procedures (odds ratio 1.922, 95% confidence interval 1.690–2.185).

CONCLUSIONS: Men undergoing BPH surgeries in OR settings were more likely to receive opioid prescriptions postoperatively, suggesting potential over-prescription. Despite similar cumulative opioid use, differences in prescription rates indicate a need for improved postoperative pain management strategies, possibly using non-opioid alternatives. Future research should focus on optimizing pain control, characterizing actual opioid consumption, and considering patient-specific factors in surgical decision-making.

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Published

2025-01-14

How to Cite

Gressler, L. E., Sze, C., Punyala, A., Martinez-Diaz, S., Bhojani, N., Zorn, K. C., … Bilal Chughtai. (2025). Opioid prescribing patterns following surgical interventions for benign prostatic hyperplasia. Canadian Urological Association Journal, 19(5), E160–5. https://doi.org/10.5489/cuaj.8958

Issue

Vol. 19 No. 5 (2025): CUAJ May

Section

Original Research

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