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Ketamine-associated lower urinary tract destruction: a new radiological challenge
K Mason1, A M Cottrell, A G Corrigan
1Bristol Royal Infirmary, Bristol, UK. k.mason@doctors.org.uk
Clinical Radiology
|August 28, 2010
Summary
Illicit ketamine abuse causes severe urinary tract damage, including bladder wall thickening and ureteric strictures. Early diagnosis through imaging is crucial to prevent irreversible kidney damage and guide treatment.
Area of Science:
- Radiology
- Urology
- Toxicology
Background:
- Ketamine, a dissociative anesthetic, is increasingly used illicitly, with users often unaware of its severe long-term health consequences.
- Ketamine abuse is strongly linked to significant urinary tract dysfunction, presenting as frequency, nocturia, dysuria, hematuria, and incontinence.
Purpose of the Study:
- To describe the common radiological findings in patients with a history of ketamine abuse presenting with severe lower urinary tract symptoms (LUTS).
- To correlate clinical, radiological, and pathological findings to confirm ketamine-induced bladder pathology.
Main Methods:
- A series of 23 patients with a history of ketamine abuse and LUTS underwent imaging, including ultrasonography (US), intravenous urography (IVU), and computed tomography (CT).
- Radiological findings were reviewed, and patients with positive results underwent cystoscopy and bladder wall biopsies for diagnosis confirmation.
Main Results:
- Ultrasound revealed small bladder volume and wall thickening.
- CT demonstrated marked bladder wall thickening, mucosal enhancement, perivesical inflammation, and ureteric wall thickening.
- Advanced cases showed ureteric narrowing and strictures on CT and IVU.
Conclusions:
- Ketamine abuse leads to significant, identifiable urinary tract pathology.
- Radiological findings are key to diagnosing ketamine-induced bladder damage.
- Early diagnosis and intervention are essential to prevent irreversible renal damage and guide management.
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