Ketoconazole for prevention of postoperative penile erection

Objectives. To determine if ketoconazole, an inhibitor of testosterone synthesis, can prevent postoperative spontaneous erections in patients undergoing penile surgery. Methods. Ketoconazole was administered to 8 patients, aged 14 to 42 years, who underwent penile surgery. All patients received ketoconazole 400 mg orally three times daily starting on the day of surgery. Liver function tests were obtained preoperatively and after the completion of treatment. Results. Ketoconazole successfully prevented erections in all patients. None of the patients demonstrated liver function abnormalities. Conclusions. Ketoconazole is a reliable method to prevent postoperative penile erection. With the proper monitoring of liver function tests and the avoidance of drug interactions, ketoconazole therapy also appears to be safe.