Ketamine-induced vesicopathy: a literature review

Abstract

International audienceIntroduction - Ketamine consumption in on the increase as a recreationally abuses substance. It is reported to cause lower urinary tract symptoms and published accounts of its deleterious effects are increasing. We reviewed the available literature regarding the urological impact of Ketamine abuse and its management. Methods - twenty two publications were found in total after a search of all databases including Pubmed, Medline and Google Scholar using the words "ketamine", "bladder" and "cystitis" with no limits imposed. Results - There are approximately 110 cases reported in the literature in the form of case series, case reports and letters. The effect of ketamine abuse on the bladder is universally similar however there is no uniform method adopted in reporting the symptoms, diagnosis and management. Very little is known regarding the pathogenesis of its effects on the urinary tract. Discussion - Patients with severe irritative lower urinary tract symptoms, a positive history of ketamine abuse and the absence of any other aetiology should be considered to have ketamine induced vesicopathy, (KIV). Effort must be made to elicit the history of drug abuse in those with no found cause of lower urinary tract symptoms especially in the young. Presently ketamine cessation is only effective treatment modality to prevent deterioration of the renal function and indeed offer the possibility of symptom resolution. Management akin to that formulated for IC patients would appear to offer the greatest opportunity for effective treatmen