Opioid dependency has been a persistent issue in the United States over the past two decades. Increased efforts have been made to reduce opioid prescribing. Our objective was to quantify at-home opioid requirements following radical prostatectomy. Written questionnaires were administered to patients 1 week following robot-assisted laparoscopic radical prostatectomy (RALP). Patients provided data on opioid use, pain levels, and demographic characteristics. Sixty-five patients were included. Median age (interquartile range [IQR]) was 69 (62-72) years. The majority were white (85%) and hispanic (67%). Prescriptions ranged from 6 to 15 pills of 5-mg oxycodone equivalents. Twenty-two percent (145/663) of the prescribed pills in the study were consumed. Fifty-four percent (35/65) of patients did not take opioids. Of the 30 patients who took opioids, median use (IQR) was 4.5 (3-6) pills. Forty-six percent (30/65) reported catheter-related pain. Patients who took opioids reported higher levels of pain. On generalized linear regression, younger age, lower levels of education, and living with a family member were factors associated with increased risk for opioid use (all < 0.05). Despite the Florida Department of Health's restriction on narcotic prescriptions to 3-day supplies, opioids are still overprescribed in our region. The majority of patients do not require opioids after RALP, and patients who do require an opioid analgesic can be adequately managed with less than 6 pills of 5-mg oxycodone equivalents.
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http://dx.doi.org/10.1089/end.2022.0212 | DOI Listing |
Int J Surg
January 2025
Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Yunnan, China.
BJUI Compass
January 2025
Department of Cellular and Molecular Medicine KU Leuven Leuven Belgium.
Objectives: Lymphedema of the lower limbs and pubic area is a potential complication following extended pelvic lymph node dissection (ePLND) during robot-assisted radical prostatectomy (RARP). The incidence of lymphedema after ePLND has not been systematically reported in the literature. This study aimed to determine the incidence of lymphedema, describe its clinical characteristics and identify specific risk factors in patients undergoing RARP with or without ePLND.
View Article and Find Full Text PDFObjectives: This study aimed to assess the impact of anterior hood-sparing robot-assisted radical prostatectomy (RARP) with posterior-anterior reconstruction in a single-surgeon series by analysing oncological and functional continence outcomes.
Patients And Methods: We carried out a cohort comparison study of a prospectively collected single-surgeon series. The surgeon was an 'in-training' fellowship trained surgeon in their first 2 years of independent practice.
J Laparoendosc Adv Surg Tech A
January 2025
Department of Urology, University of Illinois at Chicago, Chicago, Illinois, USA.
The Da Vinci single-port (SP) platform is being used more frequently in radical prostatectomy (RP). In this study we aimed to compare the complications and oncological outcomes of the Da Vinci SP platform in robotic-assisted radical prostatectomy (SP-RARP) between elderly and young age-groups and to further examine differences between young-old and old-old patients. Data from 193 patients who underwent SP-RARP between December 2018 and June 2024 were analyzed.
View Article and Find Full Text PDFNat Rev Urol
January 2025
Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Anterior prostate cancers (APCs) are a group of impalpable neoplasms located in regions anterior to the urethra, which comprise the transition zone, apical peripheral zone and anterior fibromuscular stroma. These regions are typically undersampled using conventional biopsy schemes, leading to a low detection rate for APC and a high rate of false negatives. Radical prostatectomy series suggest prevalence rates of at least 10-30%, but transperineal systematic biopsy is ideal for diagnosis, particularly where multiparametric MRI is unavailable.
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