Ketamine-related urological complications: radiological features

Abstract

Objective: To describe the radio graphical features of patients with ketamine-related urological complications. Methods: All ketamine users who presented to the Urology Division of our hospital during June 2006 to July 2009 were included in this study. Investigations including renal function test, ultrasound, intravenous urogram, micturating cysto-urethrogram, antegrade pyelogram, renal scintigraphy, and computed tomography were performed as appropriate. Their medical records, radiological reports, and corresponding images were reviewed. Results: A total of 36 patients were included in this study, in which 19% had bilateral hydronephrosis, 8% had unilateral hydronephrosis, and 72% of the patients had no hydronephrosis. Moreover, 6% of the patients with bilateral hydronephrosis had renal stones, and 6% had increased renal parenchymal echogenicity on ultrasound; 11% of patients had episodic or continuously elevated serum creatinine levels. Bilateral ureteral narrowing was demonstrated in 14% of the patients, and features of cystitis were documented in 39%. Bladder stones were detected in 6% of patients, and 11% had a percutaneous nephrostomy. Conclusion: Ketamine abuse can lead to irreversible damage to the urinary tract, causing cystitis, urinary tract stones, hydronephrosis, renal parenchymal disease, and renal failure. Radiological investigations such as ultrasound and intravenous urogram have an important role in the assessment of these complications. Percutaneous nephrostomy offers relief of significant urinary tract obstruction. © 2012 Hong Kong College of Radiologists.