Can ketamine prescribed for pain cause damage to the urinary tract?

Storr, TM; Quibell, Rachel

doi:10.1177/0269216309106828

Cited by 43 publications

(34 citation statements)

References 5 publications

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“…5 The typical clinical manifestations of LUTS after long-term ketamine abuse include severe dysuria, painful haematuria, urinary urgency, urge incontinence, frequency, 1,2,7 and nocturia. 8,9 Urine cultures including searches for acid-fast bacilli in early-morning urine samples 2,10 were negative, though individuals subsequently develop concomitant urinary tract bacterial infections that are considered to be secondary. 11 A few patients present with sterile pyuria 8,12,13 or proteinuria.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…8,9 Urine cultures including searches for acid-fast bacilli in early-morning urine samples 2,10 were negative, though individuals subsequently develop concomitant urinary tract bacterial infections that are considered to be secondary. 11 A few patients present with sterile pyuria 8,12,13 or proteinuria. 12 Enhanced bladder wall thickness and lower-than-normal urinary bladder volume, with or without upper urinary tract disorder (thickened ureteral wall and dilatation, hydronephrosis, and renal impairment) have also been described.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…1,13,[20][21][22] Regrettably, ketamine cessation is not an effective means of relieving all symptoms in every patient completely; symptoms may be partially alleviated only and impaired quality of life often persists. 1,8,23 It has been reported that after stopping of ketamine use, in about a third of cases LUTS resolve, in another third symptoms progress, and in the remainder there is no change. 24 Another large study reported a 51% improvement in urinary symptoms upon cessation, but about 4% of patients endured deteriorating symptoms even after stopping ketamine.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…11,16 Cystoscopic findings classically associated with IC are detailed in the Table. 1,2,7,8,[10][11][12][13][16][17][18]20,24,[26][27][28][29][30][31][32][33][34][35] They include low bladder capacity, contracted bladder, marked inflammation consistent with in-situ carcinoma or significant infection, 8 severe bladder ulceration, 1,16 multiple erythematous swelling 12,13 with necrotic mucosa, 13 various degrees of epithelial inflammation with neovascularisation and petechial haemorrhages, 11 or cystitis glandularis confirmed by biopsies only. 2 It has been noted that after cystodilation or cystoscopy on filling the bladder, there may be erythematous bladder bleeding, 21 glomerulation (bladder haemorrhages) and mucosal bleeding diffusely into the lumen, 28 and even persistent active bleeding from a bladder ulcer 16 (Fig 2).…”

Section: Clinical Featuresmentioning

confidence: 99%

“…29 Some patients with serious bladder lesions show no surface epithelium, but only smooth muscle (Fig 3), collagen and adipose tissue. 8 The bladder mucosa is typically erythematous, 26 with or without ulcerative and haemorrhagic cystitis. 1,21 Finally bladder tissue fibrosis supervenes, 12 without dysplasia or malignancy.…”

Section: Clinical Featuresmentioning

confidence: 99%

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Genitourinary toxicity of ketamine

Wei

Yang²,

Yin³

et al. 2013

Hong Kong Med J

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341Ketamine is a relatively new recreational drug used by youngsters in recent decades. Its toxic effects on the genitourinary system were first reported in 2007, and now attract extensive attention from urologists, pharmacologists, and toxicologists all over the world. As many front-line health professionals and medical social workers are still unaware of this new clinical entity and an increasing number of the drug users seek help for urological symptoms, this mini-review aimed to summarise the clinical features and possible mechanisms of ketamine-induced genitourinary toxicity. By raising public awareness of these toxic effects, the authors hope that the contents of this review will be widely disseminated not only to medical professionals, but also to relevant government departments and the general public. Genitourinary toxicity of ketamine

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Section: Clinical Featuresmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

See 3 more Smart Citations

Genitourinary toxicity of ketamine

Wei

Yang²,

Yin³

et al. 2013

Hong Kong Med J

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1,2-Diarylethylamine- and Ketamine-Based New Psychoactive Substances

Wallach

Brandt

2018

Handbook of Experimental Pharmacology

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While phencyclidine (PCP) and ketamine remain the most well-studied and widely known dissociative drugs, a number of other agents have appeared since the late 1950s and early 1960s, when the pharmacological potential of this class was first realized. For example, hundreds of compounds have been pursued as part of legitimate research efforts to explore these agents. Some of these found their way out of the research labs and onto illicit markets of the 1960s and following decades as PCP analogs. Other "illicit analogs" apparently never appeared in the scientific literature prior to their existence on clandestine markets, thus originating as novel innovations in the minds of clandestine chemists and their colleagues. Like so much else in this world, new technologies changed this dynamic. In the 1990s individuals separated by vast geographical distances could now communicate nearly instantaneously with ease through the Internet. Some individuals used this newly found opportunity to discuss the chemistry and psychoactive effects of dissociative drugs as well as to collaborate on the design and development of novel dissociative compounds. Similar to modern pharmaceutical companies and academic researchers, these seekers tinkered with the structure of their leads pursuing goals such as improved duration of action, analgesic effects, and reduced toxicity. Whether all these goals were achieved for any individual compound remains to be seen, but their creations have been let out of the bag and are now materialized as defined compositions of matter. Moreover, these creations now exist not only in and of themselves but live on further as permutations into various novel analogs and derivatives. In some cases these compounds have made their way to academic labs where potential clinical applications have been identified. These compounds reached wider distribution when other individuals picked up on these discussions and began to market them as "research chemicals" or "legal highs". The result is a continuously evolving game that is being played between legislatures, law enforcement, and research chemical market players. Two structurally distinct classes that have appeared as dissociative-based new psychoactive substances (NPS) are the 1,2-diarylethylamines and β-keto-arylcyclohexylamines. Examples of the former include diphenidine and various analogs such as fluorolintane and N-ethyl-lanicemine, and examples of the latter are analogs of ketamine such as methoxetamine, deschloroketamine, and 2-fluoro-2-deschloroketamine. The subject of this chapter is the introduction to some of the dissociative NPS from these classes and their known pharmacology that have emerged on the market in recent years.

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