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MATT ROSENBERG
Pelvic Pain and the Use of Ketamine
31 August 2009: 9 Messages
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1
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Recent reports have associated pelvic pain and the past/current use of ketamine. Does anyone in the group have experience with this?
I have been reviewing this through various articles and am looking for any insights that the group may have gained.
Matt T Rosenberg (matttoren@yahoo.com)
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2
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I have a case of street ketamine causing bladder necrosis and per literature review recommended elmiron. Patient lost to follow-up.
Michael Hermans (MHERMANS@SWMAIL.SW.ORG)
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3
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See attached article: it is endemic in parts of Malaysia !
Clarence Lei Chang Moh (clarencelei@GMAIL.COM)
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4
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I had a couple of cases of severe bladder fibrosis and contracted bladder. They had bilateral hydronephrosis and hydroureter because of the small bladder although the serum creatinine was
normal. Treatment would be elmiron and anticholinergics. If they do not improve, they need surgical augmentation of the bladder.
Kok Bin Lim (limkokbin@YAHOO.COM.SG)
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5
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Ketamine abuse is common in Asia. The drug commonly comes in capsule or powdered form. The patients are usually in the 20s and 30s. They usually
consume ketamine as recreational drugs and after a certain period (about 6 months to 1 year) start developing urinary symptoms and painful bladder. The patients realize that further consumption of ketamine relieves their painful symptoms
temporarily, and a vicious circle ensues. The bladder inflammation eventually results in severe scarring leading to bilateral hydronephrosis.
Hui Meng TAN (perandro@STREAMYX.COM)
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6
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Does anyone know the mechanism of ketamine injury to the bladder? Is this something that has only been described with recreational use of the drug, or should we be concerned that it may
apply to its use as an anesthetic as well? Finally, is there any warning/ labeling of ketamine that pertains to these described effects on the bladder?
Abraham Morgentaler (amorgent@YAHOO.COM)
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7
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Ketamine bladder occurs only with ‘street’ ketamine, and is probably due to some contamination or byproduct. Mechanism unknown as yet. But disease usually does not progress on cessation of
use.
Clarence Lei Chang Moh (clarencelei@GMAIL.COM)
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8
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I have seen 3 patients so far that have ketamine associated cystitis. I would call it cystitis as it resulted in a contracted small capacity bladder almost similar to severe interstitial
cystitis. The histology shows chronic inflammatory cell infiltrate and eosinophils. The bladder mucosa splits in various regions and starts bleeding on distention. It only results from chronic ketamine use and not from anesthesia.
Shawket Alkhayal (salkhayal@HOTMAIL.COM)
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