Jansonius Annelies, Oddens Jorg R
Jeroen Bosch ziekenhuis, afd. Urologie,'s-Hertogenbosch, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(10):A4176.
Ketamine is used as an anaesthetic and in third-line pain management. Furthermore, recreational use of the drug is becoming increasingly popular due to its dissociative and hallucinogenic effects. Ketamine can affect the urothelium, possibly with long-term damage to the bladder and kidneys. An otherwise healthy, 22-year-old female smoker was referred to our clinic. Shortly after starting recreational ketamine she experienced gross haematuria, urgency, frequency and dysuria. There had been no febrile episodes or flank pain. Her urine cultures were sterile. Physical examination, blood tests, urinary cytology and abdominal ultrasound results were normal. A severely inflamed bladder was seen during cystoscopy. Biopsies showed denuded urothelium and inflammation of the submucosa without malignancy. The precise mechanism of ketamine-associated urological symptoms is currently unknown. Treatment, therefore, is symptom-targeted and cessation of ketamine is imperative. We recommend that ketamine use is considered in patients with otherwise unexplained urological symptoms.
氯胺酮用作麻醉剂及用于三线疼痛管理。此外，由于其解离和致幻作用，该药物的娱乐性使用正变得越来越普遍。氯胺酮可影响尿路上皮，可能会对膀胱和肾脏造成长期损害。一名22岁、身体健康的吸烟女性被转诊至我们的诊所。开始娱乐性使用氯胺酮后不久，她出现了肉眼血尿、尿急、尿频和尿痛。没有发热发作或胁腹疼痛。她的尿培养无菌。体格检查、血液检查、尿液细胞学检查和腹部超声结果均正常。膀胱镜检查时可见膀胱严重发炎。活检显示尿路上皮剥脱和黏膜下层炎症，无恶性病变。目前尚不清楚氯胺酮相关泌尿系统症状的确切机制。因此，治疗以症状为靶点，必须停止使用氯胺酮。我们建议，对于有其他无法解释的泌尿系统症状的患者，应考虑是否使用过氯胺酮。
