Mp64-05 Trends in Post Operative Use of Opioids in Male to Female Penile Inversion With Creation of Neovaginal Canal Transgender Vaginoplasties

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) II (MP64)1 May 2024MP64-05 TRENDS IN POST OPERATIVE USE OF OPIOIDS IN MALE TO FEMALE PENILE INVERSION WITH CREATION OF NEOVAGINAL CANAL TRANSGENDER VAGINOPLASTIES Courtney Berg, Gabriel Fernandez, Anh Nguyen, Nitin Patel, and Jonathan Keith Courtney BergCourtney Berg , Gabriel FernandezGabriel Fernandez , Anh NguyenAnh Nguyen , Nitin PatelNitin Patel , and Jonathan KeithJonathan Keith View All Author Informationhttps://doi.org/10.1097/01.JU.0001008824.92877.7f.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Given the opioid crisis and over prescription of narcotics, there has been an increase in implementation of the enhanced recovery after surgery protocols. Surgeons have incorporated multimodal pain control regimens to minimize opioid usage post operatively. We aim to compare post operative use of opioids in our transgender vaginoplasty without and with the addition of gabapentin. METHODS: A retrospective study was conducted to review all transgender penile inversion with creation of neovaginal canal vaginoplasties performed between 06/2020 to 10/2023 at two institutions by a single group of surgeons. Our vaginoplasty technique consists of penile inversion with creation of neoclitoris and neovulva with penile skin and neovaginal canal creation with penile skin, scrotal skin and peritoneal graft. The neovaginal space is created robotically with a multi-port robot at our institution and the apex of the neovagina robotically anchored to the peritoneum. Local anesthetic with liposomal bupivacaine is routinely used for all our vaginoplasty patients. Patient demographics including age, body mass index (BMI), and race were collected. Daily inpatient post operative morphine milligram equivalents (MME) were calculated and analyzed with or without the addition of standing gabapentin TID. RESULTS: A total of 76 patients were included in this analysis. The average age was 31.4 (range 18-58) years. The median BMI was 26. 46 patients (61%) were on gabapentin post operatively. Overall, the highest use of MME was on POD 2 and POD 3 with 39.6 and 39.5, respectively. The added total MME use for patients on gabapentin was 236.3 compared to 288.7 in patients without gabapentin. The daily average MME for patients is seen in Figure 1 (p<0.001). CONCLUSIONS: A multimodal pain regimen including gabapentin can reduce overall MME in post operative vaginoplasty. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1042 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Courtney Berg More articles by this author Gabriel Fernandez More articles by this author Anh Nguyen More articles by this author Nitin Patel More articles by this author Jonathan Keith More articles by this author Expand All Advertisement PDF downloadLoading ...