What urologists need to know about ketamine‐induced uropathy: A systematic review

@article{Castellani2020WhatUN,
  title={What urologists need to know about ketamine‐induced uropathy: A systematic review},
  author={Daniele Castellani and Giacomo Maria Pirola and Marilena Gubbiotti and Emanuele Rubilotta and Kalyan Gudaru and Andrea Gregori and Marco Dellabella},
  journal={Neurourology and Urodynamics},
  year={2020},
  volume={39},
  pages={1049 - 1062}
}
Ketamine is a general anesthetic. Dissociative effects and low cost led ketamine becoming an illegal recreational drug in young adults. Ketamine‐induced uropathy (KIU) is one of the complications observed in abusers. This study aimed to provide a systematic literature review on KIU clinical presentation, pathophysiology, and treatments. 
Is medicinal ketamine associated with urinary dysfunction issues? Assessment of both the European Medicines Agency (EMA) and the UK Yellow Card Scheme pharmacovigilance database‐related reports
A range of ketamine‐induced uropathy (KIU) issues have been typically described in ketamine misusers. Conversely, more knowledge is needed in terms of medicinal ketamine‐related urological
Rodent models of ketamine‐induced cystitis
TLDR
There are considerable variations in the rodent models used for studying KIC in terms of the strain of the animal being used; dose, duration, and route of ketamine administration to induce KIC, and assessment of pathological features.
Ketamine-induced urological toxicity: potential mechanisms and translation for adults with mood disorders receiving ketamine treatment.
TLDR
There is no evidence that ketamine and/or esketamine treatment in adults with mood disorders is associated with KIUT, but all patients receiving ketamine/esketamine for mood disorder treatment should be queried about genitourinary symptoms during acute and, where applicable, maintenance dosing.
Molecular Pathophysiology and Potential Therapeutic Strategies of Ketamine-Related Cystitis
TLDR
Evidence of molecular mechanisms of KC and potential treatment strategies for KC are summarized to help better understand the mechanism and develop an effective treatment for KC.
Triad of obstructive uropathy, cholestasis, and pneumomediastinum associated with chronic ketamine abuse: a case report
TLDR
Chronic ketamine abuse by sniffing may be associated with multiorgan toxicity, and ketamine cystitis may be followed by obstructive complications leading to acute renal failure, which may lead to acute kidney failure.
Intravesical hyaluronic acid therapy after bladder autoaugmentation by transurethral vesicomyotomy for ketamine cystitis: is it helpful?
TLDR
It is speculated that enhancing the urothelial barrier with intravesical HA therapy could be of primary importance for persistent symptomatic relief and corresponding protection of renal function, as a post-operative supplemental therapy.
An Update of Ketamine Illicit Use
TLDR
The mechanisms of neural disinhibition underlying addiction development in ketamine-dependent patients are proposed and details of possible negative consequences focusing on long-term and recreational ketamine use for both, central and peripheral systems are included.
‘Case of the Month’ from Oxford University Hospitals, Oxford, UK: ketamine uropathy with metallic stents and obstructing calculus
TLDR
A 27-year-old female attended the Emergency Department (ED) with a 1 week of progressive knee pain, left groin pain, and urinary frequency, and was not clinically septic and was passing urine with a normal renal function.
...
...

References

SHOWING 1-10 OF 92 REFERENCES
Patient characteristics for different therapeutic strategies in the management ketamine cystitis
TLDR
This study analyzed the KC patient characteristics between who received conservative management and augmentation enterocystoplasty (AE) and found no difference in patient characteristics.
Is Urodynamic Study a Good Witness to the Progression of Ketamine‐Associated Cystitis?
TLDR
Urodynamic parameters according to the dose and duration of ketamine use are evaluated and the value of urodynamic studies in determining the severity of ketamines‐associated cystitis (KC) is investigated.
Ketamine‐Induced Uropathy: A New Clinical Entity Causing Lower Urinary Tract Symptoms
TLDR
Observations and management on urinary tract damage caused by ketamine abuse and lower urinary tract symptoms (LUTS) are presented.
'Street ketamine'-associated bladder dysfunction: a report of ten cases.
Ten young ketamine abusers presented with lower urinary tract symptoms to two regional hospitals in Hong Kong. Investigations demonstrated contracted bladders and other urinary tract abnormalities.
The destruction of the lower urinary tract by ketamine abuse: a new syndrome?
To report the clinical spectrum seen in young abusers of street‐ketamine (regular recreational abusers of street‐ketamine, for its hallucinogenic effects) in Hong Kong, presenting with significant
One‐stop clinic for ketamine‐associated uropathy: report on service delivery model, patients' characteristics and non‐invasive investigations at baseline by a cross‐sectional study in a prospective cohort of 318 teenagers and young adults
To describe a service delivery model and report the baseline characteristics of patients investigated by a non‐invasive approach for ketamine‐associated uropathy.
The clinical presentation and diagnosis of ketamine-associated urinary tract dysfunction in Singapore.
TLDR
Substance abuse should be considered in young adult patients who present with severe debilitating symptoms such as lower urinary tract symptoms, even though the use of controlled substances is rare in Singapore.
Ketamine: an update on its abuse.
TLDR
Ketamine is a dissociative anesthetic and substance of abuse that can alter numerous functions in the brain including color perception, memory, attention, cognition, reaction time, and sense of time and can produce psychological addiction.
...
...