Abstract
We report about a 25-year-old patient with transnasal ketamine abuse over years presenting with severe irritative urinary dysfunction (imperative urinary urgency, pollakisuria, dysuria) and severe alguria. Cystoscopia showed ketamine-induced vesicopathy with errosive cystitis; other etiologies could be excluded. Despite serious effort the patient was not motivated for abstinence from ketamine. After two ineffecient therapies with botulinum toxin A (200 and 400 I. E.) injected into the bladder, a prostate preserving cystectomia and ileum neobladder were mandatory.
© Georg Thieme Verlag KG Stuttgart · New York.
MeSH terms
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Administration, Intranasal
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Administration, Intravesical
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Adult
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Analgesics / administration & dosage
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Analgesics / adverse effects*
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Botulinum Toxins, Type A / administration & dosage
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Cystectomy
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Cystitis / chemically induced
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Cystitis / diagnosis
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Cystitis / rehabilitation
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HIV Seropositivity / physiopathology
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HIV Seropositivity / psychology
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Humans
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Ketamine / administration & dosage
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Ketamine / adverse effects*
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Male
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Patient Compliance / psychology
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Substance-Related Disorders / complications*
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Substance-Related Disorders / diagnosis*
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Substance-Related Disorders / rehabilitation
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Urinary Diversion
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Urination Disorders / chemically induced*
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Urination Disorders / diagnosis
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Urination Disorders / rehabilitation
Substances
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Analgesics
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Ketamine
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Botulinum Toxins, Type A