“…2 Since then, numerous cases of genitourinary system dysfunction, including reduced functional bladder capacity, hydronephrosis, urinary tract infection, and interstitial cystitis, associated with ketamine use have been reported. 3,4,5,6 The mechanism of these impairments remains unclear, although histopathologic examination of the tissue removed by cystoscopic biopsy, have suggested that ketamine metabolites induce mild to severe infiltration of inflammatory cells into the urothelium. 7,8 Ketamine has also been associated with higher levels of cytochrome c and specific caspases that induce apoptosis of urothelial cells.…”