The recreational use of ketamine is increasing in popularity due to its dissociative and paralytic effects, ease of availability and low cost. However, serious and frequently irreversible damage to the urinary tract is a recently recognised side effect of recreational ketamine use. The authors present a case of a young male patient with a 2-year history of troublesome lower urinary tract symptoms and a 5-year history of ketamine consumption. Medical management of such patients is largely limited to analgesia alone, and cessation of ketamine use before irreversible damage occurs remains the best means of avoiding the radical reconstructive surgery required in end-stage disease. This case and an accompanying review of the available literature illustrate the importance of early recognition of ketamine bladder syndrome in recreational users.
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