Objective: To determine the diagnosis, treatment, and pathogenesis of ketamine-associated cystitis.
Methods: Clinical data from 3 patients with ketamine-associated cystitis were analyzed retrospectively and discussed in light of relevant literature.
Results: In the 3 cases, 2 presented severe lower urinary tract symptoms, including frequency, urgency, dysuria, urge incontinence, and painful haematuria. Urinalysis and urine culture were negative. Imaging examination demonstrated thickening of the bladder wall and a small capacity. Inflammatory changes in the bladder mucosa were observed by cystoscopy and biopsies. After cessation of ketamine use, with the addition of steroids or hydrodistension, the symptoms in the 3 patients improved. The symptoms recurred in 2 patients, as 1 was exposed to ketamine again and 1 had severe bladder contraction after for 3 - 4 month follow-up.
Conclusion: Ketamine-associated cystitis is a new urinary system inflammatory damage. Its etiology and treatment methods are not clear. Early abstinence from ketamine use and early treatment are crucial for patients with ketamine-associated cystitis to avoid irreversible damage.