KETAMINE CYSTITIS: A SYSTEMIC REVIEW AND METANALYSIS OF SURGICAL OUTCOMES OF RECONSTRUCTIVE SURGERY

Vizgan G1, Farooq M1, Prishtina L1, Blaivas J1

1. Institute for Bladder and Prostate Research

KEYWORDS: Painful Bladder Syndrome/Interstitial Cystitis (IC), Bladder Outlet Obstruction , Surgery, Underactive Bladder, Overactive Bladder

Discovered in 1960, Ketamine hydrochloride is a glutamatergic N-methyl-D-aspartate antagonist and is used as a short-acting, but powerful, dissociative anesthetic employed in both human and veterinary medicine for the induction and maintenance of general anesthesia. However, its use as an anesthetic has been limited due to its hallucinogenic side effects, which have been described as a “near death” or “out of body” experience and generally occur during waking from the anesthetic [1]. Most recently, in March 2019 the FDA approved a ketamine based nasal spray as an antidepressant.

Amongst those involved in the UK’s “dance-scene,” the prevalence of ketamine use is 42% and has increased at approximately a 50% rate per year over a 5-year period from 1999 to 2003 [2]. A British Crime Survey [3] reported an increase in the rate ketamine abuse by 16–59 year olds by 0.1% between 2006 and 2007. In 2006 ketamine was made a Class C substance via the Misuse of Drugs Act, and in 2007 0.8% of individuals aged 16—24 reported using ketamine in the last year. Ketamine is thought to be particularly popular in Asia, as the INCB reported in 2012 that 99% of all ketamine seizures worldwide took place in Asia. By the end of 2014 it was found that approximately 1% of the US population aged 16-24 had used ketamine recreationally.

Refractory ketamine cystitis (RKC) has devastating effects on the lower urinary tract (LUT) - disabling bladder pain, urinary frequency and small capacity bladder with low compliance leading to ureteral obstruction and even renal failure. The only effective treatment for RKC is major surgical reconstruction or urinary diversion (UD). Nevertheless, there is a paucity of awareness about this destructive condition. The aim of this study is to analyze the outcomes of reconstructive lower urinary tract surgery (RLUTS) in patients with RKC.

Read the full abstract text here: [ Ссылка ]

свернуть