title: Urinary symptoms and impaired quality of life in female ketamine users: persistence after cessation of use.
abstract: OBJECTIVE
  To compare the urinary symptoms and quality of life in ex-ketamine abusers and controls.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A hospital in Hong Kong.
  
  
  METHODS
  Female ex-ketamine abusers admitted to a local drug rehabilitation centre and age-matched controls attending a general gynaecology clinic between December 2009 and April 2010.
  
  
  METHODS
  Evaluation of urinary symptoms based on a 3-day bladder diary, and responses to the Urogenital Distress Inventory Short Form (UDI-6) and the Incontinence Impact Questionnaire Short Form (IIQ-7). The study group had repeat measurements 3 months later.
  
  
  RESULTS
  Overall, 90% of ex-ketamine abusers had active urinary symptoms. On average, they had increased 24-hour urinary frequency (10.0 vs 5.8; P=0.001) and lower maximum voided volume (253.3 mL vs 401.9 mL; P<0.001) compared to controls. Correspondingly, the median functional bladder capacity was smaller (195.3 mL vs 261.2 mL; P=0.011) and the mean UDI-6 and IIQ-7 scores were higher (P<0.001). Among those who abused ketamine for 2 years or more, the mean UDI-6 and IIQ-7 scores were higher (P=0.03, P=0.02 respectively). When they stopped abusing ketamine for 3 months or more, their mean 24-hour urinary frequency had decreased (P=0.03), the maximum voided volume had increased (P=0.03) and the mean UDI-6 and IIQ-7 scores had decreased (P=0.04, P=0.02 respectively), although they were still higher than in controls. After 3 more months, in the ex-ketamine abusers there had been a further decrease in 24-hour urinary frequency (P=0.01) and a further improvement in quality of life based on mean UDI-6 scores (P=0.04) but nevertheless poorer than the control group (P<0.01).
  
  
  CONCLUSIONS
  Female ex-ketamine abusers had significant urinary symptoms affecting their quality of life when studied at a mean of 8 (range, 0.5-48) months after cessation of use. The symptom severity was inversely correlated with the duration of cessation; though they improved with time, some still persisted.
authors.affiliation: Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. rachelcheung@cuhk.edu.hk
authors.forename: R Y K
authors.initials: RY
authors.lastname: Cheung
authors.forename: S S C
authors.initials: SS
authors.lastname: Chan
authors.forename: J H S
authors.initials: JH
authors.lastname: Lee
authors.forename: A W L
authors.initials: AW
authors.lastname: Pang
authors.forename: K W
authors.initials: KW
authors.lastname: Choy
authors.forename: T K H
authors.initials: TK
authors.lastname: Chung
mesh_terms: D015992:Body Mass Index; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects*; D005260:Female; D052776:Female Urogenital Diseases / Q000139:chemically induced*; D006801:Humans; D007649:Ketamine / Q000009:adverse effects*; D011446:Prospective Studies; D011788:Quality of Life; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors*; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology; D014549:Urinary Incontinence / Q000139:chemically induced*
chemical_list: D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D007649:Ketamine