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More TOP patients required a narcotic prescription (60.9% vs 35.9% vs 33.3%, respectively; P = .01 compared to patients undergoing initial stent or URS. However, when an opioid prescription was provided, the total morphine milligram equivalents prescribed among each group was not statistically significant. Patients electing initial treatment with TOP for renal colic due to stone disease were more likely to require narcotic prescriptions than patients electing initial surgical intervention. Patients electing initial treatment with TOP