Substance abuse effects on urinary tract: methamphetamine and ketamine

Area of Science:

• Urology
• Toxicology
• Addiction Medicine

Background:

• Ketamine is a known cause of urinary tract dysfunction.
• Methamphetamine (MA) abuse is an increasing public health concern, particularly in Asia.
• The comparative urological toxicity of MA and ketamine abuse requires further investigation.

Purpose of the Study:

• To investigate and compare the symptomatology and voiding function in patients abusing MA versus ketamine.
• To determine the distinct urinary tract toxicity profiles associated with MA and ketamine abuse.

Main Methods:

• A prospective cohort study included 38 patients with MA- or ketamine-related urological disorders over 23 months.
• Data collected included demographics, symptomatology, urinary symptom questionnaires, and the Montreal Cognitive Assessment (MoCA).
• Patients with polysubstance abuse were excluded, and data were analyzed comparatively between ketamine and MA abuse groups.

Main Results:

• Urinary frequency was the most common symptom in both groups.
• Dysuria was significantly more prevalent in ketamine abusers (43.5%) compared to MA abusers (6.7%).
• MA abuse was associated with a trend towards increased hesitancy and predominantly storage symptoms, with less dysuria and pelvic pain compared to ketamine.

Conclusions:

• Both MA and ketamine abuse lead to urinary tract dysfunction.
• MA abuse is primarily associated with urinary storage symptoms, while ketamine abuse is more frequently linked to dysuria and pelvic pain.
• Cognitive impairment was observed in both MA and ketamine abusing patient groups.