Ketamine-induced cystitis: A case report and literature review.
Juan Felipe Betancur, Melina González Diaz Granados, Nancy Toro, Julian Quiceno, Charles Johan Saldarriaga Espinosa, Beatriz Ramirez, Gustavo Matute
Radiology case reports December 1, 2024 DOI: 10.1016/j.radcr.2024.08.053 via PubMed
Summary
AI-generated from the abstractChronic recreational ketamine use can cause ketamine-induced cystitis, a condition marked by bladder and ureter thickening, hematuria, and pelvic pain. A 46-year-old man with HIV who used ketamine daily for 7 months presented with hypogastric pain and blood in urine. CT scans showed irregular thickening of both ureters, dilated kidney drainage tubes, and a thickened bladder wall. Procedures confirmed the diagnosis, and treatment—stopping ketamine, pain management, and psychiatric and urological support—led to symptom improvement. The case underscores the need to recognize urinary tract damage from ketamine and to use a multidisciplinary care approach.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 46-year-old Caucasian male with HIV and daily recreational ketamine use for 7 months |
| Interventions | ketamine withdrawal pain relief bilateral flexible ureteropyeloscopy bladder transurethral resection bladder fulguration |
| Topics | Ketamine |
| Keywords | Bladder thickening Hematuria Recreational drug use Ureteropyeloscopy Ketamine abuse |
| Citations | 3 |
| Key finding | Chronic ketamine abuse can cause ketamine-induced cystitis with bilateral ureteral thickening and bladder wall thickening, treatable by ketamine withdrawal and multidisciplinary support. |
Abstract
Ketamine, a dissociative anesthetic drug, has gained popularity as a recreational substance, particularly among young adults. However, chronic ketamine abuse can lead to various complications including ketamine-induced cystitis. We present the case of a 46-year-old Caucasian male with a history of HIV infection and daily recreational ketamine use for 7 months, who was admitted to the emergency room with hypogastric pain and hematuria. Laboratory examinations and contrast-enhanced abdominal CT tomography revealed significant irregular circumferential thickening of both ureters, substantial bilateral pyeloureteral ectasia, and a bladder with markedly thickened walls. Bilateral flexible ureteropyeloscopy, bladder transurethral resection, and bladder fulguration were performed, and pathology confirmed the diagnosis of ketamine-induced cystitis. Treatment consisted of ketamine withdrawal, pain relief, and support from psychiatrists and urologists. The patient's symptoms improved and he was discharged without complications. This case highlights the importance of recognizing the potential adverse effects of recreational ketamine use and the need for a multidisciplinary approach to managing ketamine-induced cystitis. Further research is necessary to elucidate the precise mechanisms underlying this condition and develop effective prevention and treatment strategies.