Ketamine-associated urinary tract dysfunction: an underrecognized clinical entity

Urol Int. 2012;89(1):93-6. doi: 10.1159/000338098. Epub 2012 Jun 16.


Introduction: The use of ketamine as a recreational drug is on the increase among young adults attending clubs and parties. Recreational ketamine users have anecdotally reported increased lower urinary tract symptoms while using the substance.

Methods: We describe the severe lower urinary tract symptoms experienced in 6 patients with chronic recreational ketamine use. We obtained a detailed history and physical examination along with further investigation to identify a relationship between recreational ketamine use and these symptoms.

Results: The urine cultures were sterile in all cases. Intravenous urography was performed in 3 patients and demonstrated bilateral upper ureteric narrow, mild bilateral hydronephrosis and contracted bladder urodynamic studies showed detrusor instability with urinary leakage when the bladder was filled to a capacity of 30- 50 ml. Cystoscopy revealed a small capacity bladder with erythematous lesions throughout the bladder. Bladder biopsies were performed in 3 patients and showed up as chronic cystitis. Ketamine cessation along with intravesical sodium hyaluronate solution appeared to provide some symptomatic relief.

Conclusion: Ketamine-associated urinary tract dysfunction appears to be a relatively new clinical phenomenon. The pathological mechanism of ketamine-associated urinary tract dysfunction is unknown and current management strategies are ketamine cessation along with intravesical sodium hyaluronate solution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravesical
  • Adult
  • Biopsy
  • China
  • Cystoscopy
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage
  • Illicit Drugs / adverse effects*
  • Ketamine / adverse effects*
  • Lower Urinary Tract Symptoms / chemically induced*
  • Lower Urinary Tract Symptoms / diagnosis
  • Lower Urinary Tract Symptoms / drug therapy
  • Lower Urinary Tract Symptoms / physiopathology
  • Male
  • Predictive Value of Tests
  • Severity of Illness Index
  • Substance-Related Disorders / complications*
  • Treatment Outcome
  • Urinary Tract / drug effects*
  • Urinary Tract / physiopathology
  • Urodynamics
  • Urography
  • Young Adult


  • Illicit Drugs
  • Ketamine
  • Hyaluronic Acid