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Medicine (Baltimore). 2019 Jun;98(23):e15943. doi: 10.1097/MD.0000000000015943.

Epidemiologic characteristics and risk factors in patients with ketamine-associated lower urinary tract symptoms accompanied by urinary tract infection: A cross-sectional study.

Liu W1,2, Wu W3, Wei Y1,4, Wu J4, Li T4, Zhu Q4, Ye L4, Hong F2, Gao Y5, Yang J5.

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Shengli Clinical Medical College of Fujian Medical University.
Department of Nephrology, Fujian Provincial Hospital.
Department of Neurology, Union Hospital, Fujian Medical University.
Department of Urology, Fujian Provincial Hospital, Fuzhou.
Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, China.


Young adults with longstanding ketamine abuse present with lower urinary tract symptoms (LUTSs), which may be accompanied by urinary tract infection (UTI). However, the morbidity and risk factors for ketamine-associated LUTS accompanied by UTI (KALAUTI) are still unknown. To ascertain these, we surveyed patients with a history of ketamine abuse and LUTS at the time of their initial presentation.One hundred untreated patients with ketamine-associated LUTS were initially surveyed at 3 medical institutions. The patients' basic demographic and clinical information, KALAUTI status, and possible risk factors were obtained via a questionnaire and analyzed.Eighty-one patients were finally enrolled. Eight patients (9.88%) had a definitive diagnosis of KALAUTI and 16 (19.75%) had suspected KALAUTI. The diagnosis of KALAUTI was ruled out in the remaining 57 patients (70.37%). Patients with upper urinary tract involvement, longer duration of drug use, or more severe LUTS (Pā€Š<ā€Š.05), were more prone to KALAUTI. Frequent urine culture and a higher voiding symptom score (VSS) were risk factors for KALAUTI (Pā€Š<ā€Š.05), increasing the risk of KALAUTI by 44.241- and 1.923-fold, respectively.The study indicates that frequent urine culture and severe VSS are risk factors for KALAUTI. The possibility of UTI should be considered in ketamine abusers with LUTS in the clinical setting.

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