Lee Py, Ong Ta, Chua Cb, Lei Ccm, Teh Gc
MFamMed, Department of Family Medicine, Faculty of Medicine & Health Sciences, University Malaysia Sarawak, Kuching, Sarawak. (Lee Ping Yein).
FRCS, Department of Surgery, Faculty of Medicine & Health Sciences, University Malaysia Sarawak, Kuching, Sarawak. (Ong Teng Aik).
Malays Fam Physician. 2009 Apr 30;4(1):15-8. eCollection 2009.
Ketamine is frequently abused nowadays as a recreational drug. Case reports are emerging since 2007 to describe a new clinical entity of severe bladder dysfunction associated with chronic abuse of street ketamine.
Severe lower urinary tract symptoms of urinary frequency and urgency which are refractory to conventional treatment. Quality of life is adversely affected as a consequence. Chronic kidney disease will develop in advanced cases. Investigation findings: The urine is sterile on culture. Ultrasound will show reduced bladder capacity with thickened bladder wall. In advanced stage, hydronephrosis and renal impairment will develop.
Patients should be advised to stop street ketamine use immediately. Anticholinergic medication could be tried to alleviate the symptoms. Refractory cases with dilatation of the upper urinary tract might need urinary diversion.
Awareness of this new condition is essential in diagnosis. Early intervention offers better treatment outcome.
氯胺酮如今常被滥用为娱乐性药物。自2007年以来，不断有病例报告描述一种与长期滥用街头氯胺酮相关的严重膀胱功能障碍的新临床实体。
出现严重的下尿路症状，如尿频和尿急，对传统治疗无效。结果生活质量受到不利影响。晚期病例会发展为慢性肾病。检查结果：尿液培养无菌。超声显示膀胱容量减小，膀胱壁增厚。晚期会出现肾积水和肾功能损害。
应建议患者立即停止使用街头氯胺酮。可尝试使用抗胆碱能药物缓解症状。上尿路扩张的难治性病例可能需要进行尿流改道。
认识这种新情况对诊断至关重要。早期干预可带来更好的治疗效果。
