Case report of ketamine-induced urinary tract injury
November 7, 2011, 12:00 am
Ketamine-associated vesicopathy. Chen YC, Chen YL et al. QJM 2011 Sep 14 [Epub ahead of print]
No abstract available
An under-recognized complication of chronic ketamine abuse is injury to the bladder. Ketamine or a metabolite gets concentrated in the urine, causing inflammation, fibrosis, and decreased compliance. These patients — typically young males — present with severe lower urinary tract symptoms (urgency, frequency, dysuria0 and suprapubic pain. Work-up reveals a small-capacity bladder (sometimes less than 100 mL) with a thick wall. Secondary hydronephrosis can cause renal failure.
Differential diagnosis includes interstitial cystitis, tuberculous cystitis, and transitional cell carcinoma.
This brief case report describes an 18-year-old male who present with bladder inflammation and scarring after abusing ketamine for 3 years. Symptoms improved rapidly when he ceased exposure to ketamine. The paper has good images of the intravenous urogram, cystoscopy, and bladder biopsy.