assessment of ketamine uropathy

A group of experts on lower urinary tract dysfunction and cystitis met together to make a consensus report on the assessment of ketamine uropathy (KU) which encompasses ketamine cystitis. Essential tests, which should be performed in all KU patients, are (1) detailed history taking with structured questionnaire, (2) physical examination, (3) urine tests including test strip biochemistry and sediments analysis, urine culture, and cytology, (4) blood tests including complete blood cell counts with differential counts, liver and renal function tests, IgE, HIV, VDRL, (5) urological tests including uroflowmetry and post void residual urine volume and renosonography. Optional tests, which will be performed in selective cases, are (1) bladder diary for 48-72 hours, (2) bladder wall thickness by ultrasound, (3) upper tract evaluation with excretory urography, computed tomography of abdomen, diuretic renal scan, (4) lower urinary tract evaluation with cystoscopy, voiding cystography, urodynamics or videourodynamics, (5) bladder and/or ureteral biopsy, (6) abdominal echo and/or gastroendoscope. Optional tests are usually indicated when essential tests disclose abnormal findings. Using the standardized tools to assess patients with ketamine abuse, patients characteristics can be clarified and different therapeutic strategies for ketamine uropathy can be compared in the future.