(PD2-2) Patient characteristics for different therapeutic strategies in the management of ketamine cystitis
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  • 2015-11-30,
  • 上傳者: TUA秘書處,
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K他命膀胱炎患者之特性與其治療策略的選擇
李宇坤、郭漢崇
花蓮慈濟醫院 泌尿部
Patient characteristics for different therapeutic strategies in the management of ketamine cystitis
Yu-khun lee, hann-chorng kuo
Department of Urology, Hualien Tzu Chi Hospital, Huelien, Taiwan
 
Purpose:
This study analyzed the ketamine cystutus(KC) patient characteristics between who received conservative management and augmentation enterocystoplasty (AE).
Materials and Methods:
A total of 53 patients with chronic ketamine abuse and lower urinary tract symptoms visiting urological clinic of a tertiary teaching hospital in Eastern Taiwan were included in this study. All of the patients have been initially treated conservatively but failed. They were admitted for detailed urological examinations including cystoscopic hydrodistention and urinary tract image study. Patients were classified according to their maximal bladder capacity (MBC). The patients with extremely small MBC (<100ml) with or without upper urinary tract damage and very small MBC with upper urinary tract damage were recommended to receive AE. The other patients were recommended to receive symptomatic treatment. The patient characteristics and bladder condition are compared between patients with AE and conservative treatment. Treatment outcome was also assessed in these two groups.
Results:
Among the participants, 28 patients underwent AE and 25 were managed with conservative treatment. The only significant difference between groups was more patients with urgency urinary incontinence (UUI) underwent AE. Patients underwent AE had significantly smaller MBC, thicker bladder wall, and higher incidence of vesicoureteral reflux. Significantly more patients underwent AE reported a good outcome. Most of the patients received conservative treatment only had a fair result.
Conclusions:
KC patients who already developed a contracted bladder with extremely small bladder capacity (<100ml) or very small capacity (100-300ml) with irreversible urinary tract change, partial cystectomy and AE seems necessary for early restoration of a normal lower urinary tract function. The treatment outcome of AE is better than patients with conservative treatment.
 
 
 
 
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