Taking opioid painkillers after a vasectomy may lead more patients to become addicted to the narcotic painkillers, according to the findings of a new study.
Men who took opioids post-operatively were more likely to continue persistent use months later, compared to the men who did not take opioids and managed their vasectomy pain in other ways, according to findings published earlier this month in the Journal of Urology.
The findings were part of a position paper by the American Urological Association (AUA), which recommends using opioids after vasectomy only when necessary.
The retrospective study included 228 patients who underwent vasectomy at a clinic with one of eight urologists between April 2017 and March 2018. Patients were organized into two groups, with a total of 102 patients initially prescribed opioids and another 126 placed into a group that did not receive opioid prescriptions after a vasectomy.
Initial pain medication regimen depended on the standard prescription practice of each doctor. Two urologists routinely prescribed opioids for pain after surgery, while the other six used other pain control methods, such as over-the-counter medications such as Advil and Tylenol, scrotal support, and ice.
Doctor overprescribing is largely implicated in the country’s opioid epidemic. Many doctors are rewarded by drug companies for prescribing more opioids, and recent research indicates doctors’ prescribe opioids without a documented pain diagnosis 30% of the time.
In the new study, researchers compared visits to a doctor for scrotal pain within 30 days, subsequent opioid prescriptions, and new persistent opioid prescriptions between 90 and 180 days.
Nearly 13% of patients given opioids returned to the doctor after surgery because of scrotal pain. Comparatively, 18% of the patients not given opioids returned to the doctor after surgery due to scrotal pain.
Researchers said there was “no statistically significant difference” between opioid and non-opioid groups regarding scrotal pain after surgery. Being initially prescribed narcotic painkillers like Vicodin or Norco after surgery did not decrease the odds of scrotal pain.
However, men who already received an opioid prescription were more likely to receive another prescription compared to those who didn’t initially receive a prescription. Nearly 10% of men in the opioid group received another prescription after the first round was complete, compared to 2% of the non-opioid group.
Not receiving narcotic painkillers after surgery made a man less likely to need painkillers later.Men who initially received prescriptions of OxyContin and other opioid painkillers had significantly higher rates of persistent use. Among them, 8% were more likely to become addicted to painkillers three months later, compared to only 1.5% in the group that did not get opioids.
Other research has shown opioids are often overprescribed after surgeries where alternative forms of pain management can be used. Nearly half of all patients prescribed opioids don’t need them to manage the pain.
This latest study’s findings also indicated the dosages of opioids prescribed vasectomy patients were likely “far more than would be required for adequate pain control,” the researchers warned.
They calculated that routine prescribing of opioids after vasectomy would prevent about 6% of follow-up doctors’ visits for pain, yet would lead to 8% more patients becoming addicted to painkillers, which they deemed to be an unacceptable trade-off.