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Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents
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[Ketamine-induced vesicopathy].

Martin Lieb1, Markus Bader, Ulrich Palm

  • 1Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik, Ludwig-Maximilians-Universität, München. martin.lieb@med.unimuenchen.de

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Summary
This summary is machine-generated.

Long-term ketamine abuse can cause severe bladder damage, leading to urinary dysfunction. In a case study, even after multiple treatments, a patient required bladder removal and reconstruction due to ketamine-induced cystitis.

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Area of Science:

  • Urology
  • Toxicology
  • Drug Abuse

Background:

  • Ketamine, a dissociative anesthetic, is increasingly abused recreationally.
  • Chronic ketamine use is associated with significant urinary tract toxicity.
  • Understanding the spectrum of ketamine-induced uropathy is crucial for clinical management.

Observation:

  • A 25-year-old patient presented with chronic transnasal ketamine abuse.
  • Symptoms included severe irritative urinary dysfunction: urgency, frequency, dysuria, and pain.
  • Cystoscopy revealed erosive cystitis consistent with ketamine-induced vesicopathy.

Findings:

  • Despite extensive efforts, the patient was unwilling to abstain from ketamine.
  • Two ineffective intravesical botulinum toxin A therapies (200 and 400 IU) were administered.
  • Surgical intervention, including prostate-preserving cystectomy and ileal neobladder, became necessary.

Implications:

  • This case highlights the severe and potentially irreversible bladder damage from chronic ketamine abuse.
  • It underscores the challenges in managing ketamine-induced cystitis, especially in non-abstinent patients.
  • Radical surgical management may be the only option for refractory cases, emphasizing the need for substance abuse intervention.