Ketamine-Associated Uropathy: From Presentation to Management

Ketamine consumption as a recreational drug is on an increasing trend. Chronic abuse of ketamine leads to ketamine-associated uropathy, commonly presenting with lower urinary tract symptoms and suprapubic pain. Upper tract involvement is observed in a portion of patients. Inflammatory picture and hypersensitive reaction are observed in the histopathology of ketamine cystitis specimen. Assessment with symptom score questionnaires, imaging assistance and endoscopic examination are essential in the evaluation of patients with ketamine-associated uropathy. While abstinence is the key to alleviate the detrimental impact from ketamine abuse, both medical and surgical options are available to relieve the complications. This review discussed the clinical presentation, pathology, assessment and management strategy of ketamine-associated uropathy.