Abstracts from the New England Section of the AUA 2020: A Virtual Experience

© The Canadian Journal of Urology TM : International Supplement, August 2020 Effect of Treatment Status on Affective Status of Patients with Prostate Cancer: A Pilot Study William C. Daly, BS 1 , Madeline C. Rutan, BS 1 , Paul KJ Han, MD, MA, MPH 1 , Christina Gentile, MPH 1 , Matthew Hayn, MD 2 , Moritz H. Hansen, MD 2 , Jesse D. Sammon, DO 2 1 MaineMedicalCenterResearchInstitute,Center forOutcomesResearchandEvaluation,Portland, ME, USA; 2 Maine Medical Center Department of Urology, Portland, ME, USA Introduction: Active surveillance (AS) has increasingly become the preferred option in the management of low-risk prostate cancer (PCa). This option potentially involves greater uncertainty and worry for patients, although little is known about the extent of this uncertainty. The goal of this exploratory study was to measure uncertainty, as well as anxiety andworry, amongAS patients and in patients pursuing other treatment strategies. Materials & Methods: We developed a patient survey consisting of 17 items designed to assess PCa patients’ level of anxiety, uncertainty and of worry, which were measured using a 4-point Likert scale. We piloted the survey among all PCa patients seen at a multi- physician urology clinic between September and December 2018. For this initial study, we limited our analysis to the 6 items that focused on cancer specific worry and anxiety (Figure 1.). We combined these items into a 24-point summary score. We used descriptive statistics, ANOVA, and Mann-Whitney U tests to compare the survey responses of AS patients vs. patients receiving treatment as well as patients in other treatment groups. Results: Cronbach’s alpha for the six items was 0.90. A total of 253 patients returned complete surveys: 50 AS patients, 144 RP patients, and 59 patients in the process of deciding or who opted for another active treatment (Other). When compared to patients undergoing active treatment, patients undergoing AS had did not differ significantly in regards to worry about cancer progression or recurrence. Patients at a decision point and patients who were prior to treatment had significantly higher cancer worry scores than those not at a decision point or those post-treatment (p < 0.001 in both cases). Patients with no evidence of disease (NED) trended towards lower worry scores, but not to a significant degree (p = 0.123). Conclusions: Patients undergoing AS did not have significantly more worry about cancer progression or recurrence. Patients prior to treatment or at decision points in their treatment were more worried that those that were not, which presents an opportunity for psychosocial intervention or further counseling to improve patient quality of life at these times. P24 A Retrospective Evaluation of a Novel Perioperative Opioid Sparing Protocol for Patients Undergoing Robotic Assisted Laparoscopic Radical Prostatectomy or Nephrectomy David M. Krok, PharmD , Lisa Rameaka, MD, Henry Cabrera, MD, Joseph Renzulli, MD South County Hospital, Wakefield, RI, USA Introduction: The over-prescribing of opioid analgesics by healthcare providers has significantly contributed to the national opioid epidemic. The purpose of this study is to evaluate the opioid-sparing effect of a non-opioid perioperative regimen in patients receiving either a robotic assisted laparoscopic prostatectomy or nephrectomy. Materials &Methods: Aretrospective cohort study was conducted between patients who received an opioid-sparing regimen and those who had not received this regimen. Patients enrolled in the treatment group received a perioperative blister-pack of medications to start three days prior to surgery and seven days postoperatively upon discharge.Average length of stay, numeric pain scores, quantity of opioids utilized in the inpatient post-operative period, the presence of an opioid prescription at discharge, and outpatient 7-day post- discharge phone calls were collected. Results: Of the 97 patients included in the study, 12 patients out of 27 (44.4%) patients in the control group were discharged with an opioid prescription as compared to 2 of 70 (2.9%) patients in the treatment group. There were also significant differences in total oral milligrammorphine equivalents utilizedwhile inpatient (49.38mg vs. 17.38mg) in patients with no history of chronic opioid use, average length of stay (2.11 days vs. 1.49 days) and average outpatient pain scores seven days after discharge (3.73 vs. 1.67). Conclusions: A non-opioid perioperative regimen can result in similar post-operative pain control and fewer opioid prescriptions being written at discharge. By decreasing the number of patients requiring opioids post operatively, there is the potential to have a positive impact on the opioid epidemic. The greatest impact being the reduction of opioid prescriptions prescribed upon discharge. P23 Poster Session II 40