Ketamine-induced uropathy

Ketamine-induced uropathy is a growing cause of severe urinary problems in young adults due to increasing recreational ketamine use. While urinary symptoms are uncommon in healthy young people, especially men, ketamine misuse is changing this pattern. The drug, originally developed as an anesthetic, is now widely used recreationally, particularly among people aged 16–25.

Ketamine is metabolized into substances that damage the bladder lining, causing inflammation, fibrosis, and reduced bladder capacity. Common symptoms include urinary frequency, urgency, severe bladder pain, blood in the urine, and urge incontinence. In advanced cases, the condition can affect the ureters and kidneys, potentially leading to renal failure. Because symptoms mimic urinary tract infections, diagnosis is often delayed, and antibiotics are ineffective.

Severity is linked to frequency and duration of ketamine use, and symptoms can progress rapidly. Stopping ketamine is the most important step in treatment, with about half of patients improving after cessation. Management may include bladder medications, pain control, bladder instillations, or botulinum toxin injections. In severe cases, reconstructive surgery may be required.

Early recognition is essential, as timely intervention can prevent permanent, life-altering urinary damage.

Nazarko, L. (2026). Ketamine uropathy. Urology & Continence Care Today. https://www.ucc-today.com/journals/issue/launch-edition/article/ketamine-uropathy