愷他命膀胱炎臨床症狀與預後因子評估

黃亮鋼、許毓昭*、陳煜、謝明里、黃世聰、黃信介、張博誌、李威昌

林口長庚紀念醫院外科部 泌尿科系

Urologic symptoms and prognostic factors for ketamine cystitis

Liang-Kang Huang, Yu-Chao Hsu*, Yu Chen, Ming-Li Hsieh, Shih-Tsung Huang, Hsin-Chieh Huang, Po-Chih Chang, Wei-Chang Lee

Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou medical center, Taoyuan, Taiwan

Background:

Ketamine-related cystitis is a serious of symptoms followed by ketamine use. The low urinary tract symptoms (LUTS) include bladder pain, urinary frequency, urgency, and even urge incontinence. As the addiction patients to ketamine increased, more and more patients suffer from low urinary tract symptoms and were called ketamine-related cystitis. However, in the ketamine abuse populations, not everyone developed into urologic symptoms and the reason is unknown. In our study, we review the chart of ketamine patients who came to urologic outpatient clinic with low urinary tract symptoms mentioned above and try to identify the risk factor of urologic problems in ketamine abusers.

Material and Methods:

Patients from August 2011 to November 2015 who came to urological clinic in our hospital who diagnosed as ketamine-related cystitis were included. Low urinary tract symptoms were recorded by voiding diary, OABSS score, and pain score. Drug addiction history was report by patient themselves and record in their charts. 

Results:

A total of 111 patients were included in this study. Most patient (96%) with low urinary tract symptoms (LUTS) sniffing the ketamine powder instead of smoking ketamine. The symptoms severity, frequency, OABSS score, and pain score are not associated with neither dosage nor the frequency they use ketamine. Functional bladder capacity was lower in patient with long time ketamine use whos accumulative dose (daily dose by gram x the duration of usage by year) greater than 10 gram year.  (mean= 147.17 v.s. 69.69ml).  

Conclusion:

Sniffing Ketamine has higher possibility to induce LUTS rather than smoking. Ketamine use in short term might not induce voiding symptoms. The severity of low urinary tract syndrome is not associated with the dosage or frequency they use ketamine. However, the accumulative dose of ketamine is associated with functional bladder capacity and decreases the bladder capacity and lead to frequency and bladder pain.