Use of Oral Ketoconazole To Prevent Postoperative Penile Erections Following Surgery For Hypospadias

Basalat Hussain Rizvi, Hyder Ali, Mujtuba Pervez Khan, Faisal Akhlaq Ali Khan, Nasreen Bano, Seema Raza

Abstract

Objective

To assess the effectiveness of oral ketoconazole in preventing postoperative penile erections after hypospadias repair.

Study design

Cross sectional analytic study.

Place & Duration of study

Department of Plastic and Reconstructive Surgery, Dow University of Health Sciences and Dr. KM Ruth Pfau Civil Hospital Karachi, from December 2019 to July 2020.

Methods

All patients with the diagnosis of hypospadias between the ages of 4 - 40 years were included in the study. Patients were allocated into intervention group (ketoconazole group) or control group through lottery method. Patients were assessed in postoperative period for penile erection, postoperative pain and overall satisfaction related to cosmetic appearance.

Results

At total of 80 patients were enrolled. They were equally divided into two groups. At first follow-up the postoperative erections were relieved in 65% patients, pain relieved in 40%, and 45% of the patients / parents reported strong satisfaction with the outcome in ketoconazole group. At third 3rd follow-up erections were relieved in 85%, pain relieved in 75% and 57.5% reported satisfaction in the intervention group which was statistically significant (p <0.001) in comparison with the control group (35%).

Conclusion

Ketoconazole effectively inhibited postoperative erections after penile reconstructive surgery. It may be considered as a valuable adjunct for the prevention of painful erections in the early postoperative period.

Key words

Ketoconazole, Penile erections, Hypospadias, Wound dehiscence, Urethro-cutaneous fistula.