The ketamine bladder.
Peter Galloway, James Kovacic, Blake Miller, Avi Raman
Australian Journal of General Practice November 2026 DOI: 10.31128/ajgp-12-25-7956 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Esketamine Ketamine |
| Key findings | The authors describe ketamine-induced uropathy as a rare but potentially serious complication of ketamine misuse that can cause progressive bladder and upper urinary tract fibrosis, renal impairment, and the need for reconstructive surgery. They argue that general practitioners are vital for early recognition, initial management, coordination of care, support for ketamine cessation, and timely referral to a multidisciplinary team. |
Abstract
Ketamine misuse is rising in young adults in Australia. Although ketamine is often perceived as a 'soft' drug, abuse can lead to ketamine-induced uropathy (KIU), also known as ketamine bladder. Characterised by lower urinary tract symptoms, KIU can cause progressive fibrosis of the bladder and upper urinary tract, leading to renal impairment and in some cases requiring reconstructive surgery. The aim of this article is to: (1) describe the presentation and implications of KIU; (2) outline recommended investigations; (3) introduce management principles; and (4) identify key assessment aspects warranting non-general practitioner (GP) specialist referral. KIU is a rare but potentially serious complication of ketamine abuse. Awareness of KIU among GPs is vital to ensure early recognition, initial management and coordination of ongoing care. GPs play a key part in supporting ketamine cessation and coordinating timely referral to a multidisciplinary team including urology, drug and alcohol specialists, pain specialists and allied health services.
Comparable studies
Other narrative reviews on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms | 2018 | Review | |
| Mechanisms of Ketamine Action as an Antidepressant | 2018 | Review | |
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) | 2013 | Review | |
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement |