Ketamine-associated bladder dysfunction.
OBJECTIVE
To assess the impact of ketamine abuse on genitourinary tract dysfunction.


METHODS
Eleven patients with urinary tract symptoms and a history of ketamine abuse in recent years were studied. Urinalysis, urine culture, renal function tests, abdominal sonography and urodynamic studies were done. Bladder biopsies were carried out in selected cases.


RESULTS
The most common complaints were lower urinary tract symptoms, including dysuria, frequency, urgency and gross hematuria. Urinalyses showed nonbacterial pyuria and were negative for tuberculosis. All biopsy specimens showed infiltrations of granulocytes (mostly eosinophils) and mast cells within the bladder tissue. Medications produced only slight clinical improvements. Intravesical instillation of hyaluronan solution was performed for some patients and a significant improvement of lower urinary tract symptoms was observed.


CONCLUSIONS
Although the dosage and duration of ketamine abuse causing severe side-effects are still unclear, some patients develop irreversible histological changes in the urinary tract. Therefore, clinicians should be aware of the negative effects of ketamine abuse on genitourinary tract function.
Tsai
Tsung-Hsun
TH
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Cha
Tai-Lung
TL
Lin
Chang-Min
CM
Tsao
Chih-Wei
CW
Tang
Shou-Hung
SH
Chuang
Feng-Pin
FP
Wu
Sheng-Tang
ST
Sun
Guang-Huan
GH
Yu
Dah-Shyong
DS
Chang
Sun-Yran
SY
D000328:Adult; D005260:Female; D006801:Humans; D007649:Ketamine / Q000009:adverse effects*; D008297:Male; D019966:Substance-Related Disorders / Q000150:complications*; D001745:Urinary Bladder Diseases / Q000139:chemically induced* / Q000473:pathology; D055815:Young Adult
D007649:Ketamine