Objectives: Here, we review opioid-sparing or opioid-free anesthesia and pain management for urologic procedures and pathologies–urological pain syndromes, kidney stone pain management, development of post-surgical pain syndromes, and prevention. We explore acute management of perioperative pain during and after urologic procedures; additionally, we review the pathophysiology of various urologic pain syndromes along with a variety of interventions, including pharmacologic management, nerve blocks, neurolysis, and neuromodulatory therapies in hopes of educating providers who treat the urologic patient.

Methods: Relevant literature on various topics related to acute and chronic urologic pain was reviewed and incorporated into this comprehensive overview. Relevant clinical treatments and treatment guidelines for managing pain related to various urological conditions and syndromes are discussed, compared, and contrasted and conclusions are drawn.

Results and Discussion: Urological pathologies, procedures, pain syndromes and their pharmacologic and interventional pain management strategies are discussed.

Conclusion: Acute and chronic pain remain essential components of postoperative morbidity, both in the urologic patient and otherwise. The opioid epidemic has further complicated perioperative management, but effective pain control is vital to improving patient outcomes. Close collaboration between urologists, anesthesiologists, and pain specialists is critical in improving patient care. 

Urologic pain, Multimodal opioid-sparing approach, Pain management