Gourd-Shaped Bladder Associated with Ketamine Abuse

Epidemiologic characteristics and risk factors in patients with ketamine-associated lower urinary tract symptoms accompanied by urinary tract infection

“…[4] The symptoms of LUTS may be relieved in most patients after they undergo ketamine detoxification, but recur when the patients resume ketamine abuse. [1,10] However, it should be noted that some patients present with progressively worsening LUTS after quitting ketamine use several years previously. [11] In our study, the risk of UTI increased more than 1.9-fold in patients with a high VSS, compared to those with a low VSS, indicating that VSS may be an indicator for KALAUTI and suggesting that KALAUTI should be considered in patients with a history of ketamine use presenting with severe voiding symptoms.…”

Ketamine plus Alcohol: What We Know and What We Can Expect about This

“…Although the epidemiological ketamine abuse surveys have not cleared the contribution of alcohol on gastrointestinal symptoms, such reports have highlighted that the co-abuse with alcohol has been prevalent (around 30%) [ 36 , 48 , 60 ]. Considering the findings above, we suggest that the co-abuse of ketamine plus ethanol by misusers may elicit cirrhosis, as well as increase collagen fibers in the liver [ 61 , 62 ] ( Figure 1 B). Actually, an experimental study revealed that high levels of cell death via a necrosis process have been detected in the livers of rats that received a ketamine-plus-ethanol regiment [ 61 ].…”

“…Although ketamine abuse has been accompanied by alcohol intake among misusers, few clinical studies have underlined the toxicological effects that result from the association, focusing mainly on the urinary system [ 37 , 38 ]. In an experimental study, ketamine-plus-alcohol-treated animals developed atresia of glomeruli and necrotic cell in the kidney related to proteinuria, which infers renal dysfunction [ 61 , 62 ]. Such evidence suggests that ketamine–alcohol co-treatment augments the toxicological effects of both drugs per se, reducing the period of exposure to elicit nephrological impairment [ 62 ].…”

“…In an experimental study, ketamine-plus-alcohol-treated animals developed atresia of glomeruli and necrotic cell in the kidney related to proteinuria, which infers renal dysfunction [ 61 , 62 ]. Such evidence suggests that ketamine–alcohol co-treatment augments the toxicological effects of both drugs per se, reducing the period of exposure to elicit nephrological impairment [ 62 ]. However, it is unclear the pathophysiology of such toxicological synergic mechanisms.…”

“…As highlighted in this review, systemic toxicity of both drugs is another point that deserves attention. Interestingly, both ethanol and ketamine present coincidental or synergistic deleterious effects on cardiorespiratory, hepatic, and urinary tracts [ 46 , 51 , 55 , 56 , 57 , 58 , 60 , 62 , 64 , 67 , 71 , 82 , 83 ]. Some of these damages are linked to concurrent pharmacological mechanisms on glutamatergic, noradrenergic, and cholinergic pathways’ modulation, resulting in biliary motility impairment, tachycardia, respiratory disability, and intraglomerular pressure.…”