Postoperative pain management after ureteroscopy: focused approaches to reducing opiate dependence

Ureteroscopy (URS) is a common urological procedure performed to treat nephrolithiasis, but postoperative pain often leads to patient inquires, unplanned emergency department visits, or readmissions. Effective pain management is essential for improving recovery, reducing adverse symptoms, and enhancing patient satisfaction. Due to concern for opioid dependency, urologists have increasingly focused on alternative methods for pain relief, emphasizing multimodal analgesia. This narrative review, based on a PubMED search from January 2025–February 2025, examines alternative strategies for pain management. Recent studies show benefits of combining medications like nonsteroidal anti-inflammatory (NSAIDS), alpha-blockers, and anticholinergics to reduce opioid dependence. Identifying the most appropriate analgesics following URS remains a challenge, with the primary goal to optimize recovery to improve patient outcomes and satisfaction. This review looks at the best way to manage pain after ureteroscopy, which is a procedure commonly used to treat kidney stones. Patients can experience pain in their kidney area, pain when urinating, or have other urinary discomforts. Different studies have looked at the best medications that are helpful after the surgery. Studies have tested different pain combinations of medications including those without narcotics and even newer treatments to try and find best combinations to help ease pain and discomfort for patients. The studies show using a mixture of medication works best. These medications include acetaminophen ibuprofen, medications to reduce bladder spasm medication, and drugs that relax the bladder neck and the ureter. These medications taken together help ease pain and improve urinary symptoms. Using the right combination of medications can better control pain, help patients feel more comfortable, and hopefully reduce emergency room visits and unplanned admissions. Finding a balanced and safe pain regiment if beneficial to both patients and healthcare system.