膀胱擴大手術治療K他命膀胱炎
郭威廷1、王華斌1、余燦榮1、林嘉祥1, 2
1高雄義大醫院 泌尿外科；2高雄義守大學 學士後醫學系國際專班
Bladder augmentation in ketamine associated cystitis
Wei-Ting Kuo1, Hua-Pin Wang1, Tsan-Jung Yu1, Victor C. Lin1,2
1Department of Urology, E-Da Hospital, Kaohsiung, Taiwan
2School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
Purpose:
Ketamine associated cystitis presented with severe dysuria, frequency, urgency, lower abdominal pain and gross hematuria. Due to its pathologic damage, the filling bladder volume is decreased. In our hospital we performed bladder augmentation in 4 cases of ketamine associated cystitis from 2004 to 2013.
Materials and Methods:
All 4 patients was ketamine abuser and diagnosed by clinical symptoms and cystoscopic examination of ulceration with severe diffuse hemorrhage and low bladder capacity from 2004 to 2013. They all received bladder augmentation. The data on demographics, clinical characteristics, and patient outcomes were collected. All the data were yielded retrospectively.
Result:
Total of 4 patients with ketamine associated cystitis received bladder augmentation at E-Da tertiary medical center from 2004 to 2013. Male patients were predominant (male : female=3:1). The average age at operation is 29.75. ( ranged 28-32 ) The average ketamine abuse time is 9.25 years. ( ranged 8-11 ) After bladder augmentation of surgery, the post-voiding residual urinary amount increased and it improved capacity of bladder that more than 200ml. The patients are satisfied with the outcome of bladder augmentation and it improved the quality of life. Few times of urinary tract infection are encountered during follow up in 2 patients. One patient suffered from recurrent vesical stone without sepsis.
Conclusion:
We shared our experience for refractory bladder pain due to ketamine associated cystitis. The outcome of treatment depends on the severity of the disease process. Although small number cases, bladder augmentation may be needed in such patients. It improves bladder capacity and quality of life of the patients.