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Opioids vs. non-opioids makes no different in chronic back pain.(1)  There is some evidence to suggest opioids may stimulate cancer progression. (11)

One study showed allopurinol use is associated with lowered risk of BPH medication, diagnosis and surgery. A possible explanation could be antioxidative effects of urate-lowering allopurinol. decreased risk for all three BPH endpoints: BPH medication (HR 0.81; 95% CI 0.75–0.88), BPH diagnosis (HR 0.78; 95% CI 0.71–0.86) and BPH-related surgery (HR 0.67; 95% CI 0.58–0.76) after multivariable adjustment. The risk association did not change by cumulative use. The risk decrease disappeared after 1–2 years lag time. Only BMI modified the risk association; the risk decrease was observed only among men with BMI above the median (27.3 kg/m2); p for interaction <0.05 for each endpoint. (2)

Nonabsorbable sutures during Peyronie's disease repair has low levels of nodularity and bother at suture site. (3) 

NSAIDS use can reduce symptoms of UTI's allowing resolution with less antibiotic usage, however with increased complications from UTI.  (4,5)

Women who ride bicycle have higher rate of UTI's but better sexual function. (6)

Average cost of California OR time is
$36 to $37 per minute; $20 to $21 of this amount is direct cost, with $13 to $14 attributable to wages and benefits and $2.50 to $3.50 attributable to surgical supplies(7)

Perioperative gabapentin in RCT showed
a 24% increase in the rate of opioid cessation after surgery (HR, 1.24; 95% CI, 1.00-1.54; P = .05). No significant differences were noted in the number of adverse events as well as the rate of medication discontinuation due to sedation or dizziness (placebo, 42 of 202 [20.8%]; gabapentin, 52 of 208 [25.0%]). (8)

Sevoflurane is a type III (M3) muscarinic receptor antagonist may be associated with less catheter associated bladder discomfort after TURBT. (10) 


Interesting review of legal cases involving torsion found initial presenting symptoms are 48% testicular pain, 31% abdominal pain, 6% both. US was ordered 48% of time with blood flow identified 64% of the time. (9)
  1. Krebs, Erin E., et al. "Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial." JAMA 319.9 (2018): 872-882.
  2. ​Kukko, Ville, et al. "Allopurinol and risk of benign prostatic hyperplasia in a Finnish population-based cohort." Prostate cancer and prostatic diseases (2017): 1.
  3. Papagiannopoulos, D., et al. "Surgical outcomes from limiting the use of nonabsorbable suture in tunica albuginea plication for Peyronie’s disease." International journal of impotence research 29.6 (2017): 258.
  4. Kronenberg, Andreas, et al. "Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial." bmj 359 (2017): j4784.
  5. Gágyor, Ildikó, et al. "Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial." bmj 351 (2015): h6544.
  6. Gaither, Thomas W., et al. "Cycling and Female Sexual and Urinary Function: Results From a Large, Multinational, Cross-Sectional Study." The journal of sexual medicine (2018).
  7. Childers, Christopher P., and Melinda Maggard-Gibbons. "Understanding Costs of Care in the Operating Room." JAMA surgery (2018): e176233-e176233.
  8. ​Hah, Jennifer, et al. "Effect of Perioperative Gabapentin on Postoperative Pain Resolution and Opioid Cessation in a Mixed Surgical Cohort: A Randomized Clinical Trial." JAMA surgery (2017).
  9. Gaither, Thomas W., and Hillary L. Copp. “State Appellant Cases for Testicular Torsion: Case Review from 1985 to 2015.” Journal of Pediatric Urology, vol. 12, no. 5, 2016.
  10. Kim, Hyun-Chang, et al. "The effect of sevoflurane versus desflurane on postoperative catheter-related bladder discomfort in patients undergoing transurethral excision of a bladder tumour: a randomized controlled trial." Canadian Journal of Anesthesia/Journal canadien d'anesthésie 63.5 (2016): 596-602.
  11. ​Lec, Patrick M., et al. "The Role of Opioids and Their Receptors in Urologic Malignancy: A Review." The Journal of Urology (2020): 10-1097.
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