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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 (opens in new tab)

Study at a glance

AI-extracted from the abstract
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 Esketamine
Keywords Bladder thickening Hematuria Recreational drug use Ureteropyeloscopy Ketamine abuse Urinary tract damage Drug-induced cystitis Bladder disorders Recreational drug complications
Citations 3
Key findings 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.

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