‘Ketamine-induced ulcerative cystitis’ is perhaps better labelled ‘ketamine-induced uropathy’

Abstract

Morgan & Curran’s paper [1] on ketamine use concludedthat the major physical harm was ketamine-inducedurinary system damage, which they referred to asketamine-induced ulcerative cystitis. We would like todiscuss the symptoms of this condition, and whether itwould be more appropriate and concise to describe it asketamine-induced uropathy.The key symptoms of ketamine-induced uropathyare severe dysuria, painful haematuria, frequency andurgency of urination, urge incontinence and nocturia.Auxiliary examination often offered some importantfindings, including sterile pyuria, contracted bladderinvolving chronic inflammation with ulceration, ery-thematous swelling, necrotic mucosa, thin epitheliumwith neutrophilic and lymphoplasma cell infiltrationin bladder mucosa, collagen and adipose tissue andbladder wall fibrosis with or without vesico–uretericreflux and involvement of the upper urinary tract. Basedon the urinary symptoms, cystoscopy findings andpathology, earlier reports have described ketamine-induced uropathy as an interstitial cystitis-like condi-tion [2,3]. However, the cause of interstitial cystitisis unknown, while ketamine-induced uropathy ischaracterized as a series of common peculiarities withketamine abuse as the evident cause, and with symp-toms improving after cessation of ketamine use. Wesuspect that Morgan