Urological complications of illicit drug use

Nat Rev Urol. 2014 Mar;11(3):169-77. doi: 10.1038/nrurol.2014.22. Epub 2014 Feb 18.


Illicit drug use is prevalent worldwide; over 24 million people are estimated to have used recreational drugs during the past month in the UK and USA alone. Illicit drug use can result in a wide spectrum of potential medical complications that include many urological manifestations. To ensure optimal care and treatment, urologists need to be cognizant of these complications in their patients, particularly among youths. Ketamine uropathy is thought to affect over one-quarter of ketamine users and can lead to severe lower urinary tract symptoms, as well as upper tract obstruction. Cannabis use has been associated with an increased risk of bladder cancer, prostate cancer and nonseminomatous germ cell tumours in case-control studies. Fournier's gangrene has been reported following injection of heroin and cocaine into the penis. Excessive use of cough medicines can lead to the development of radiolucent stones composed of ephedrine, pseudoephedrine and guaifenesin. As the current evidence is mostly limited to case reports and case series, future epidemiological studies are needed to fully address this issue.

Publication types

  • Review

MeSH terms

  • Fournier Gangrene / chemically induced
  • Fournier Gangrene / diagnosis
  • Fournier Gangrene / therapy
  • Humans
  • Illicit Drugs / adverse effects*
  • Lower Urinary Tract Symptoms / chemically induced
  • Lower Urinary Tract Symptoms / diagnosis
  • Lower Urinary Tract Symptoms / therapy
  • Male
  • Prostatic Neoplasms / chemically induced
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / therapy
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / therapy
  • Urinary Bladder Neoplasms / chemically induced
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / therapy
  • Urologic Diseases / chemically induced*
  • Urologic Diseases / diagnosis
  • Urologic Diseases / therapy


  • Illicit Drugs