Ketamine uropathy: Clinical experience in a high prevalence center

Area of Science:

• Urology
• Toxicology
• Public Health

Background:

• Ketamine uropathy presents with severe lower urinary tract symptoms, small bladder capacity, and pelvic pain.
• Upper tract involvement, including hydronephrosis, can occur, with limited UK data and no formal treatment guidelines.
• The incidence of ketamine-induced bladder damage appears to be increasing.

Purpose of the Study:

• To describe a cohort of patients with ketamine uropathy in the UK.
• To analyze demographic, clinical, and management data.
• To inform urologists about the rising incidence and challenges in managing ketamine uropathy.

Main Methods:

• Retrospective analysis of 81 patients diagnosed with ketamine uropathy from 2011-2022.
• Data collection included demographics, symptoms, imaging, and treatment interventions.
• Follow-up duration and adherence were assessed.

Main Results:

• 81 patients identified, with a significant increase in presentations from 2018.
• 24.7% of patients had hydronephrosis, requiring nephrostomy in six cases.
• Average age at presentation was 26, with 72.8% males; adherence to follow-up was poor.

Conclusions:

• The rising incidence of ketamine uropathy is a concern for urologists, linked to increased recreational ketamine use.
• Abstinence from ketamine and a multidisciplinary approach are crucial for management.
• Formal treatment guidelines are needed due to the unusual presentation in a small UK town and poor follow-up adherence.