Ketamine bladder or ketamine bladder syndrome refers to lower urinary tract symptoms associated with long-term ketamine use.
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Epidemiology
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.
Clinical presentation
Symptoms may include 2:
- dysuria
- nocturia
- frequency
- incontinence
- hematuria
In users who infrequently take the drug, mild intermittent symptoms have been reported 2.
Radiographic features
Ultrasound
Ultrasound features may include 2:
- small bladder volume
- bladder wall thickening
CT
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.
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