Shahani · Urology 2007 · case series · n=9

Ketamine-associated ulcerative cystitis: a new clinical entity.

Cited 372 times in the scientific literature.

Level 4 - case-series / case-control

Case series of 9 patients without a control group

PubMed 17482909 · doi:10.1016/j.urology.2007.01.038 · record verified 2026-08-26

What was done

A clinical evaluation of 9 daily recreational ketamine users presenting with severe lower urinary tract symptoms (dysuria, frequency, urgency, gross hematuria). Workup included urine cultures, microscopy, cytology, computed tomography, cystoscopy, and bladder biopsies.

What was found

Urine cultures were sterile in all 9 patients. Computed tomography showed marked bladder wall thickening, small bladder capacity, and perivesicular stranding. Cystoscopy revealed severe ulcerative cystitis in all 9 patients. Biopsies in 4 patients showed epithelial denudation and inflammation with mild eosinophilic infiltrate. Ketamine cessation plus pentosan polysulfate appeared to provide some symptomatic relief.

Why it matters

This paper identifies and describes ketamine-associated ulcerative cystitis as a distinct clinical entity resulting from chronic recreational use.

Limits

Small retrospective case series of only 9 patients without a control group. Only 4 patients underwent biopsy, and the abstract provides no specific data on dose, duration of use, or quantitative long-term outcomes.

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