Prophylactic Low-Dose Esketamine for Prevention of Intraoperative Penile Erection During Ureteroscopic Surgery Under General Anesthesia: A Randomized, Double-Blind, Placebo-Controlled Trial.

Drug Des Devel TherOct 21, 2026 (epub)
Case ReportAnesthesiologyUrologyOpen access

Zijie Zhang, Guojiang Yin, Wanting He et al.

✦ AI-curated · Sources linked

Condensed from the publisher's abstract. An xxcode editorial summary of this publication has not been generated yet.

From the abstract

Intraoperative penile erection (IPE) during ureteroscopic surgery may interrupt surgical procedures and increase the risk of urethral injury. Existing management strategies are largely reactive and frequently require rescue interventions after erection has already developed. Effective prophylactic strategies remain limited.

Reported results

The incidence of IPE was 6.2% (11/178) with esketamine versus 21.9% (39/178) with saline (RR 0.282, 95% CI 0.149-0.533; ARR 15.7%; NNT 6.4; P < 0.001). Porst grades were lower in the esketamine group during disinfection, ureteroscope insertion, and 10 min after surgery commenced, and fewer patients required rescue treatment for clinically significant erection (Porst grade ≥ 2, 4.5% vs 21.3%; P < 0.001).

Authors' conclusions

Prophylactic low-dose esketamine was associated with a lower incidence and severity of intraoperative penile erection, without evidence of impaired postoperative recovery. These findings suggest that prophylactic esketamine may be a useful strategy for preventing this perioperative complication, warranting confirmation in larger multicenter trials.

Source

PubMed · PMID 42928869Free full text on PubMed Central

Published in Drug Des Devel Ther. The text above is extracted from the publisher's own abstract and has not been edited by xxcode. For clinical decisions, review the original publication.

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