Abstract
Objective To study the methods and efficiency of cystectasia in the treatment of ketamine-associated urocystic contracture. Methods Eighteen cases including 15 males and 3 females from 6 hospitals with ketamine-associated urocystic contracture from 2010 July to 2016 February were selected and analyzed. All patients were with drawal from ketamine and treated by weekly cystectasia with 0.09% sodium hyaluronate balance solution 3 times. Two times the preoperative bladder capacity balance solution was instilled in the cystoscope under direct vision for the first time, followed by an increase of 100 ml each time through urinary catheter. The Pelvic Pain and Urgency/Frequency symptom score (PUF), O'Leary-Sant IC Symptom Index (ICSI) and IC Problem Index (ICPI), QOL score and bladder capacity were recorded before the surgery, and during three and twelve months follow-up after the third expansion. Results All 18 patients were treated by cystectasia 3 times without significant complications such as intraoperative bleeding and bladder rupture. Two cases were lost after surgery. Two cases took ketamine again after 8 months. Fourteen cases were followed up at least 12 months. The mean PUF before the surgery, and three and twelve months follow-up after the third expansion were (20.4±3.6), (11.5±3.1) and (13.2±3.3) respectivly. The mean ICSI were (13.6±2.8), (7.7±2.3) and (8.2±2.5) respectivly. The mean ICPI were (10.6±2.6), (7.3±2.1) and (7.7±2.5) respectivly. The mean QOL score were (6.0±0), (2.1±0.5) and (2.7±0.8) respectivly. The mean bladder capacity were (83±27) ml, (234±56) ml and (228±52) ml respectivly. All postoperative indicators showed significant differences compared to the preoperative indicators. Conclusions Cystectasia with sodium hyaluronate balance solution is an effective way in the treatment of ketamine-associated urocystic contracture and the surgery is easy to perform and well tolerated. Key words: Ketamine; Urocystic contracture; Cystectasia; Sodium hyaluronate
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