Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Research
  • Published:

Use of oral ketoconazole to prevent postoperative erections following penile surgery

International Journal of Impotence Research volume 16, pages 346–349 (2004)Cite this article

Abstract

Analgesics and topical agents ineffectively inhibit painful erections after penile and urethral surgery. Oral ketoconazole reversibly inhibits testosterone production and has been used empirically at our institution to decrease postoperative erections. We performed a retrospective review of 38 patients who had undergone penile and urethral reconstructive surgery. In all, 31 patients received 400 mg of ketoconazole three times daily for 10–14 days postoperatively (the study group) and seven patients did not receive ketoconazole (the control group). The incidence of postoperative erections, pain, side effects, surgical outcomes and patient satisfaction in each group were compared. Of the control group, 71% reported erections in the immediate postoperative period, and all these patients reported the erections were painful. Only 23% of the patient taking ketoconazole reported postoperative erections, and only 16% reported the erections were painful. We conclude that ketoconazole effectively prevents painful postoperative erections with minimal side effects.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Stock JA, Kaplan GW . Ketoconazole for prevention of postoperative penile erections. Urology 1995; 45: 308–309.

    Article  CAS  Google Scholar 

  2. Pont A et al. Ketoconazole blocks testosterone synthesis. Arch Intern Med 1982; 142: 2137–2140.

    Article  CAS  Google Scholar 

  3. Santen RJ et al. Site of action of low dose ketoconazole on androgen biosynthesis in men. J Clin Endocrinol Metab 1983; 57: 732–736.

    Article  CAS  Google Scholar 

  4. Sikka SC, Swerdloff RS, Rajfer J . In vitro inhibition of testosterone biosynthesis by ketoconazole. Endocrinology 1985; 116: 1920–1925.

    Article  CAS  Google Scholar 

  5. Trachtenberg J, Zadra J . Steriod synthesis inhibition by ketoconazole: sites of action. Clin Invest Med 1988; 11: 1–5.

    CAS  PubMed  Google Scholar 

  6. Sonino N . The use of ketoconazole as an inhibitor of steroid production. N Engl J Med 1987; 317: 812–818.

    Article  CAS  Google Scholar 

  7. Sugar A et al. Pharmacology and toxicity of high-dose ketoconazole. Antimicrob Agents Chemother 1987; 31: 1874–1878.

    Article  CAS  Google Scholar 

  8. Yahr P, Gregory JE . The medial and lateral cell groups of the sexual dimorphic area of the gerbil hypothalamus are essential for male sex behavior and act via separate pathways. Brain Res 1993; 631: 287–296.

    Article  CAS  Google Scholar 

  9. Wood RI, Williams SJ . Steroidal control of male hamster sexual behavior in ME and MPOA. Physiol Behav 2001; 72: 727–733.

    Article  CAS  Google Scholar 

  10. Edwards DA, Einhorn LC . Pre-optic and midbrain control of sexual motivation. Physiol Behav 1986; 37: 329–335.

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Disclaimers: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Defense. The investigators have adhered to the policies for protection of human subjects as prescribed in 45 CFR 46

Authors and Affiliations

  1. Urology Service, Madigan Army Medical Center, Tacoma, Washington, USA

    K C Evans, A C Peterson, H E Ruiz & R A Costabile

Authors
  1. K C Evans
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A C Peterson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H E Ruiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R A Costabile
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A C Peterson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Evans, K., Peterson, A., Ruiz, H. et al. Use of oral ketoconazole to prevent postoperative erections following penile surgery. Int J Impot Res 16, 346–349 (2004). https://doi.org/10.1038/sj.ijir.3901160

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901160

Keywords

This article is cited by

Search

Advanced search

Quick links