Ketamine-associated Ulcerative Cystitis

Well documented side effects of ketamine include altered mental status, and cardiovascular and respiratory toxicities. A new clinical entity termed ketamine-associated ulcerative cystitis characterized by irritative lower urinary tract symptoms has been reported recently. We report a case of ketamine-associated ulcerative cystitis in a 25-year-old man. He suffered progressive, painful hematuria, dysuria and suprapubic pain several days after beginning ketamine abuse. His symptoms aggravated over the next 6 months and imaging studies confirmed a contractile urinary bladder with bilateral hydronephrosis and hydroureter. Although there was partial relief of his symptoms after cessation of ketamine abuse, he now requires regular hemodialysis for end-stage renal disease.