Ketamine bladder or ketamine bladder syndrome refers to lower urinary tract symptoms associated with long-term ketamine use.
The presence of lower urinary tract symptoms in long-term ketamine users has been identified to be as high as 90% in some studies 1.
Symptoms may include 2:
In users who infrequently take the drug mild intermittent symptoms have been reported 2.
Ultrasound features may include 2:
- small bladder volume
- bladder wall thickening
Imaging features on CT may include 2:
- bladder and ureteric wall thickening
- mucosal enhancement
- perivesical inflammation
Treatment and prognosis
Treatment mainly involves cessation of the drug and analgesia. In severe cases reconstructive surgery may be required 1,2. Ureteric stricture as well as vesicovaginal fistula formation are possible complications 1-3.
- 1. Chu PS, Ma WK, Wong SC, Chu RW, Cheng CH, Wong S, Tse JM, Lau FL, Yiu MK, Man CW. The destruction of the lower urinary tract by ketamine abuse: a new syndrome?. (2008) BJU international. 102 (11): 1616-22. doi:10.1111/j.1464-410X.2008.07920.x - Pubmed
- 2. Shalom Srirangam, Joe Mercer. Ketamine bladder syndrome: an important differential diagnosis when assessing a patient with persistent lower urinary tract symptoms. (2012) BMJ Case Reports. 2012: bcr2012006447. doi:10.1136/bcr-2012-006447 - Pubmed
- 3. Mason K, Cottrell AM, Corrigan AG, Gillatt DA, Mitchelmore AE. Ketamine-associated lower urinary tract destruction: a new radiological challenge. (2010) Clinical radiology. 65 (10): 795-800. doi:10.1016/j.crad.2010.05.003 - Pubmed