Postoperative Opioid Filling Patterns in Women Undergoing Midurethral Sling Placement.

Abstract

To evaluate postoperative opioid filling patterns for patients undergoing isolated midurethral sling placement. Patients undergoing midurethral sling placement from 2005 to 2016 were identified in the Truven Health MarketScan database. We determined whether sling placement was an isolated procedure or performed in conjunction with other benign gynecologic procedures. All outpatient prescription drug claims for opioids were extracted from 28 days before surgery to 28 days after surgery. We identified the number of prescriptions filled and calculated morphine milligram equivalents (MMEs) in the allotted perioperative windows. The proportion of patients with opioid prescription claims and cumulative MMEs were compared for multiple versus isolated procedures using χ2 and Wilcoxon tests, respectively. The cohort included 153,631 patients, with 79,069 (51.5%) having an isolated procedure and 74,562 (48.5%) having multiple benign procedures. Seventy-two percent of the patients undergoing isolated midurethral sling placement received at least 1 opioid prescription in the study period compared with 79% of those undergoing combined procedures (P < 0.001). The median cumulative MMEs for isolated midurethral sling and midurethral sling + multiple procedures were 150 and 225 MMEs, respectively (P < 0.001). Across the years under study, the proportion of patients filling opioid prescription claims increased, but the median cumulative MME was unchanged. Patients undergoing isolated midurethral sling placement filled a median of 150 cumulative MMEs, and the proportion of patients filling perioperative opioid prescriptions increased over the study period.