WCE 2017: Return for Unplanned Care After Ureteroscopy – Does the Type of Pain Medication Matter?

Vancouver, Canada (UroToday.com) Dr. Preston Milburn from Baylor Scott & White, presented data that compared the effect of different postoperative pain medication on a patient’s return for unplanned care after an ureteroscopy procedure. The majority of patients receive an opioid medication for postoperative pain after ureteroscopy. Many reports have addressed the rise of opioid abuses and it is clear that the amount of pain medication prescriptions given to patients must be reduced. Dr. Milburn and team evaluated whether the strength of narcotic medication after an ureteroscopy influenced a patient’s need to return for unplanned care.

They retrospectively reviewed a total of 475 patients who underwent ureteroscopy for kidney stone removal between 2014 and 2016. They reviewed all patient history for emergency room visits, clinic visits for pain issues, phone call for pain issues, and readmission to the hospital. All narcotics that were prescribed were classified using the Drug Enforcement Agency classification.

They found that the majority of patients were prescribed a Schedule II narcotic for postoperative pain medication followed by Schedule III, IV, and over the counter, respectively. When looking at the number of emergency room visits, clinic contact, and readmission there was no statistically significant difference in these postoperative outcomes between the groups. 

Dr. Milburn concluded that the type of pain medication prescribed to patients after an ureteroscopy for kidney stone did not have a statistically significant impact on the rate of a patient’s return for unplanned care. He added that over the counter medications alone are not sufficient enough for pain control after ureteroscopy. Lastly, he stated that this study’s finding may help to improve opioid stewardship in ureteroscopy patients. 

Presented by: Preston A. Milburn 

Authors: Preston A. Milburn, Lawrence Tsai, Luke Machen, Amr Elmkresh, Erin T. Bird, Kristofer R. Wagner, Maraqan M. El Tayeb
Affiliation: Baylor Scott & White, Temple, TX

Written by: Renai Yoon, Department of Urology, University of California-Irvine at the 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.