To measure our opioid prescription rate, determine if our rate has decreased since 2019, and identify areas for future interventions to further decrease our opioid prescription rate.
We retrospectively reviewed all pediatric urology patients (age≤18 years) who underwent a procedure between October 1, 2020 and October 22, 2021. We collected data on opioid prescribing, age, sex, surgeon, procedure, ethnicity, and race. We grouped procedures into six categories: circumcision, cystoscopy with removal of foreign body/stone/stent, scrotal surgery, hypospadias repair/penile surgery, pyeloplasty/ureteral reimplant, and other.
We analyzed 821 operative cases. Only 2.2% (18/821) of discharges included an opioid prescription. The prescription rate of one pediatric urologist was 4.6% (17/369), which was higher than the other two practitioners’ (0.40%, 1/250 and 0%, 0/202) (p<0.001). The median age of patients who received an opioid prescription was older than patients without an opioid prescription (16.5 vs. 5.0 years, p<0.001). Surgery performed in an inpatient setting was more likely to result in an opioid prescription (9.7%, 3/31) than the outpatient setting (1.9%, 15/790) (p=0.03). No adverse effects of reduced opioid usage were noted.
From October 2020-October 2021, our institution had an opioid prescription rate of 2.2%. This represented a decrease from our previously reported rate of 8% in 2019. At the same time, we found no significant pain issues in our post-operative patients. Seventeen out of 18 prescriptions were written under one provider. Though heightened awareness has made a difference, targeted feedback is needed if we wish to reduce opioid usage further.

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