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Ketamine bladder is a condition caused by long-term Ketamine misuse, resulting in damage, ulceration, and inflammation of the bladder. The effects are irreversible and result in chronic bladder pain and psychological problems. Treatment focuses on reducing the symptoms, controlling the pain, and preventing further damage by stopping ketamine use.
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What Is Ketamine?
Ketamine was first developed around 60 years ago. Initially, it was used mainly as an anaesthetic for animals. However, since its development, it has proven useful in other healthcare settings.
These days, Ketamine has several medical purposes:
- As a general anaesthetic, to put people to sleep for surgery
- As an analgesic, to provide relief from pain
- As part of a specialist treatment programme for depression
Why Do People Take Ketamine?
As Ketamine became more popular in the medical world, it gained interest as a party drug. You may have heard people calling it by its other street names: special K, Kit-Kat, Vitamin K, Cat Valium, or Dorothy.
People first started using Ketamine as a recreational drug in the 1980s. At the time, people mistakenly thought it was less dangerous than other “club drugs”.
Ketamine is a dissociative drug. This means it acts on the receptors in our brain and makes reality appear distorted. Taking Ketamine can lead to certain effects some people find pleasurable. For example:
- A feeling of disconnect from reality and its problems
- Experiencing visual or auditory hallucinations (seeing or hearing things that aren’t there)
- Decreased sensitivity to pain
Is Ketamine Safe?
When used under close medical supervision Ketamine can be a useful medication. However, taking Ketamine without medical advice is dangerous. Ketamine causes a range of side effects and complications, some of which can be fatal.
A number of sedative substances, such as alcohol, have an antidepressant effect. However, the antidepressant effect of sedatives is often brief and there can be a tendency if used for that effect for the person to want to increase the dose and addiction develops.
The healthcare world is still learning about the consequences of long-term Ketamine use. One particularly worrying, but often overlooked consequence, is Ketamine Bladder Syndrome.
What is Ketamine Bladder Syndrome?
Ketamine Bladder Syndrome is a bladder condition caused by the use of Ketamine.
Other names for this condition are:
- Ketamine-associated cystitis
- Ketamine-associated urinary tract pathology
- Ketamine uropathy
- K Bladder
These names all refer to bladder damage from Ketamine.
Doctors documented the first case of Ketamine Bladder in 2007. Since then, healthcare professionals have been noticing many more cases.
What Does Ketamine Do to Your Bladder?
In Ketamine Bladder, the walls of the bladder become irritated and inflamed. Healthcare professionals refer to this inflammation as cystitis.
It is not entirely clear why Ketamine Bladder develops. Experts believe that bladder damage occurs due to the breakdown products of Ketamine.
When someone takes Ketamine, the body breaks it down into metabolites. These metabolites leave the body via the bladder. As they come into contact with the bladder wall, they cause inflammation.
If left untreated, Ketamine bladder can have serious consequences. The inflamed bladder tissue can eventually become scarred. This is called fibrosis. Once scarred, a damaged bladder cannot be fully treated without major surgery.
What Are the Symptoms of Ketamine Bladder?
If you have a Ketamine Bladder, you may experience the following symptoms:
- Pain on passing urine
- Blood in urine
- Incontinence (having accidents)
- Needing to go to the toilet more frequently
- Feeling a sense of urgency to pass urine (even when it hasn’t been long since you last went)
- Needing to get up in the night to pass urine
- Pain in the lower abdomen and pelvis area
Jamie, 29, told the BBC, “At one point I couldn’t actually pee because my blood was clotted. I actually thought my bladder was going to explode. It was the worst pain I have ever had. I never want to feel that again. I thought I was going to lose my bladder.”
How Is Ketamine Bladder Diagnosed?
Ketamine Bladder was only recently discovered as a complication of Ketamine use. Because of this, there are no clear guidelines on how to diagnose it.
- Determine whether you have inflammation in your bladder (cystitis)
- Determine if the inflammation was caused by Ketamine use
Firstly, your medical team will ask questions about your symptoms. They will also ask questions about your life to try and identify the cause of the symptoms.
Depending on your symptoms, your medical team may feel that investigations are necessary.
While some of those investigations are as straightforward as obtaining a urine sample, others might require more preparation and possibly a waiting list.
It is important to raise your concerns about your symptoms to your GP and be transparent about your Ketamine use.
For you to be able to fully concentrate on your addiction recovery whilst, at Castle Craig, it is advisable to get the necessary tests as advised by your GP prior to your admission whenever possible.
What’s the Test for Ketamine Bladder?
The following tests may be useful in diagnosing Ketamine Bladder.
Ultrasound and CT Scans
Healthcare professionals can use scans to help diagnose Ketamine Bladder. Ultrasound Scans and Computed Tomography (CT scans) can be particularly useful. These scans can look at the bladder wall for inflammation and thickening.
Cystoscopy Camera Test
Your medical team might suggest a camera test called a cystoscopy. This test involves passing a small camera into your bladder. This will allow your medical team to examine the appearance of the bladder wall. In previous cases of Ketamine Bladder, these camera tests have shown inflammation.
During the camera test, your medical team may decide to take a small tissue sample from the bladder wall. A specialist doctor will be able to look at this sample under a microscope to help reach a diagnosis.
Depending on your symptoms, your healthcare team might also send a sample to the lab to look for bacteria or bugs.
Other Causes of Bladder Symptoms
Other medical problems may be causing your urinary symptoms. Some of these are easily treatable, whilst others may be more serious.
Medical problems which may cause similar symptoms:
- Bladder cancer
- Prostate cancer
- Enlarged prostate
- Bladder stones
- Medication side effects
- Bladder or kidney infection
If you are experiencing bladder symptoms, it’s important to seek help as soon as possible. Many of these conditions can be easily treated if you seek help early.
Is There a Cure for Ketamine Bladder?
Unfortunately, there is currently no established way to treat Ketamine Bladder. Treatment is focused on reducing the symptoms and preventing further damage. It is not uncommon for symptoms to fluctuate and last for weeks or even months after stopping the use of Ketamine.
Stopping Ketamine Use
The only way to prevent Ketamine Bladder is by stopping Ketamine use completely. Stopping Ketamine may be enough to reverse the symptoms. In one study group, 51% of people said that their symptoms improved after stopping Ketamine.
Controlling the Pain and Discomfort Caused by Ketamine Bladder
The other important step in treating Ketamine Bladder is controlling the pain. Your healthcare team will give you advice on painkillers.
Nonsteroidal anti-inflammatory medications (NSAIDs), Paracetamol, sometimes other medications alone or in combination can be used to help alleviate pain. For some patients, taking certain medications rectally rather than orally prove to be more helpful.
Medication to help reduce the urgency and frequency of urination can also be trialled.
Other Treatments for Ketamine Bladder
Other treatment options are still rather experimental. One study showed that a treatment called botulinum toxin might be useful. You might have heard of botulinum toxin as Botox. It is often used in cosmetic procedures to relax wrinkles around the face. In Ketamine Bladder, doctors can use botulinum toxin to help relax the muscles in the bladder. This can help reduce the symptoms caused by the bladder muscles being overactive.
Surgery for Ketamine Bladder
If your bladder is irreversibly damaged by Ketamine, you may need surgery to remove your bladder.
Are There Other Long-Term Effects of Ketamine?
As more research is published, we are seeing the link between Ketamine use and a number of long-term consequences.
Ketamine use can cause long-term mental and psychological problems. These include poor mental well-being, memory issues, and even schizophrenia-type symptoms.
In terms of its effect on other organs, experts have also observed that long-term Ketamine use can also cause liver damage.
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Getting Help for Ketamine Bladder
People may be afraid to speak to their doctors about the symptoms of Ketamine bladder, but it’s important to remember that healthcare services are there to help you.
If you’re worried about Ketamine bladder, speak to your GP or your addiction services. Remember, it is possible to reverse the symptoms if you act early.
The best thing you can do to halt the symptoms of Ketamine Bladder is to stop taking ketamine. If you are finding it hard to stop taking Ketamine, you may be addicted and need specialist help.
At Castle Craig, our detoxification and rehab program is medically managed by a team of psychiatrists, doctors, nurses, and therapists. Our team has a wide range of experience in treating complex detoxes and medical conditions associated with addiction, including Ketamine Bladder symptoms. Our psychiatrist-led medical care for Ketamine addiction symptoms combined with our evidence-based 12-step addiction therapy programme is what makes Castle Craig a world-renowned Ketamine addiction rehab hospital.
Contact us today for more information about our Ketamine detox and Ketamine rehab programme.
7. LUTS in men. Cks.nice.org.uk. https://cks.nice.org.uk/topics/luts-in-men/background-information/causes-of-luts/. Published 2019. Accessed September 13, 2021.
8. Winstock AR, Mitcheson L, Gillatt DA, Cottrell AM. The prevalence and natural history of urinary symptoms among recreational ketamine users. BJU Int. 2012;110(11):1762-1766. doi:10.1111/j.1464-410X.2012.11028.x
9. Zeng J, Lai H, Zheng D, et al. Effective treatment of ketamine-associated cystitis with botulinum toxin type a injection combined with bladder hydrodistention. J Int Med Res. 2017;45(2):792-797. doi:10.1177/0300060517693956
10. Kalsi SS, Wood DM, Dargan PI. The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use. Emerg Health Threats J. 2011;4:7107. Published 2011 Apr 15. doi:10.3402/ehtj.v4i0.7107
This page was researched and written by Dr Giedre Putelyte, Resident Medical Officer, Castle Craig Hospital and Dr India Duane.
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