Effect of total laparoscopic ileum augmentation cystoplasty in the treatment of contracted ketamine-related cystitis

doi:10.3877/cma.j.issn.1674-3253.2026.02.005

Abstract

Abstract:

Objective

To explore the effect of total laparoscopic ileum augmentation cystoplasty in the treatment of contracted ketamine-related cystitis evaluated by imaging and urodynamics.

Methods

A total of 13 patients with contracted ketamine-related cystitis were included in this study. The age was 20-66 years. Duration of ketamine abuse ranged from 0.3 to 10.0 years. The patients were required to abstain from ketamine prior to treatment, and their symptoms were repeated or even worsened due to poor response to initial conservative treatment. Patients with severe bladder contracture (bladder volume <50 mL) and low compliance of bladder (<20 mL/cmH₂O) underwent total laparoscopic ileum augmentation cystoplasty.

Results

After operations, the VAS score [(5.69±1.93)vs (9.62±2.66) ], the number of daytime urinations [(5.00±1.58) vs (14.15±3.05)], nocturnal urinations [(3.85±1.52) vs (6.69±1.84)], bladder capacity [(241.92±29.41) vs (39.62±8.60) mL], maximum urine flow rate [(15.85±1.68) vs (11.39±2.43) mL/s], bladder compliance[(33.92±7.81) vs (23.15±7.82) mL/cmH₂O], and maximum detrusor pressure during the filling phase [(21.77±3.14) vs (30.31±6.81) cmH₂O] were significantly improved (all P<0.001). All patients experienced effective relief of bladder pain after operations, and 5 out of 10 patients with elevated creatinine levels before the operation had their creatinine levels return to normal after the operation.

Conclusion

Total laparoscopic ileum augmentation cystoplasty can effectively improve the lower urinary tract symptoms and urinary bladder storage function caused by contracted ketamine related cystitis, and further protect renal function.

Key words: Ketamine-related cystitis, Bladder contracture, Total laparoscopic, Ileum augmentation cystoplasty

Haoyu Yuan, Yuansong Xiao, Chenglin Yang, Zhengfei Hu, Zhiyong Wang, Yue Yang. Effect of total laparoscopic ileum augmentation cystoplasty in the treatment of contracted ketamine-related cystitis[J]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(02): 154-158.

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References 23

[1]	Belal M, Downey A, Doherty R, et al. British Association of Urological Surgeons Consensus statements on the management of ketamine uropathy[J]. BJU Int, 2024, 134(2): 148-154. DOI: 10.1111/bju.16404.
[2]	Zhou J, Scott C, Miab ZR, et al. Current approaches for the treatment of ketamine-induced cystitis[J]. Neurourol Urodyn, 2023, 42(3): 680-689. DOI: 10.1002/nau.25148.
[3]	Chung SD, Wang CC, Kuo HC. Augmentation enterocystoplasty is effective in relieving refractory ketamine-related bladder pain[J]. Neurourol Urodyn, 2014, 33(8): 1207-1211. DOI: 10.1002/nau.22477.
[4]	Tan S, Zhu X, Zheng Z, et al. Comparison of bladder autoaugmentation by transurethral vesicomyotomy and hydrodistention for ketamine cystitis[J]. Transl Androl Urol, 2021, 10(6): 2351-2361. DOI: 10.21037/tau-21-188.
[5]	Chung SD, Praveen Rajneesh C, Chen KC, et al. Specific impacts of ketamine on bladder dysfunction and associated histological alterations in rats-a time course validation through transmission electron microscopy[J]. Int J Mol Sci, 2022, 23(4): 2194. DOI: 10.3390/ijms23042194.
[6]	周丽, 季涛, 张稳稳, 等. 右美托咪定复合艾司氯胺酮对乳腺癌患者术后焦虑及神经精神症状的影响[J]. 徐州医科大学学报, 2025, 45(2): 79-83. DOI: 10.12467/j.issn.2096-3882.20240950.
[7]	Reinhardt S, Fode M. Bladder pain and urinary tract symptoms as a consequence of ketamine abuse[J]. Ugeskr Laeger, 2014, 176(3): 240-242.
[8]	Chen CH, Lee MH, Chen YC, et al. Ketamine-snorting associated cystitis[J]. J Formos Med Assoc, 2011, 110(12): 787-791. DOI: 10.1016/j.jfma.2011.11.010.
[9]	Jenyon T, Sole G. Bladder calcification secondary to ketamine[J]. Urol J, 2013, 10(2): 912-914.
[10]	Chan EOT, Chan VWS, Tang TST, et al. Systematic review and meta-analysis of ketamine-associated uropathy[J]. Hong Kong Med J, 2022, 28(6): 466-474. DOI: 10.12809/hkmj209194.
[11]	Ng CF, Chiu PKF, Li ML, et al. Clinical outcomes of augmentation cystoplasty in patients suffering from ketamine-related bladder contractures[J]. Int Urol Nephrol, 2013, 45(5): 1245-1251. DOI: 10.1007/s11255-013-0501-4.
[12]	Lai Y, Wu S, Ni L, et al. Ketamine-associated urinary tract dysfunction: an underrecognized clinical entity[J]. Urol Int, 2012, 89(1): 93-96. DOI: 10.1159/000338098.
[13]	Chu PS, Ma WK, Wong SC, et al. The destruction of the lower urinary tract by ketamine abuse: a new syndrome?[J]. BJU Int, 2008, 102(11): 1616-1622. DOI: 10.1111/j.1464-410X.2008.07920.x.
[14]	Shahani R, Streutker C, Dickson B, et al. Ketamine-associated ulcerative cystitis: a new clinical entity[J]. Urology, 2007, 69(5): 810-812. DOI: 10.1016/j.urology.2007.01.038.
[15]	陈莉萍, 张天宇, 柏宏伟. 膀胱扩大术治疗结核性挛缩膀胱[J/OL]. 泌尿外科杂志(电子版), 2022, 14(3): 25-29. DOI: 10.20020/j.CNKI.1674-7410.2022.03.06.
[16]	易炜, 张汉超, 杨跃, 等. 单纯肠道膀胱扩大术治疗低顺应性膀胱合并返流患者的疗效随访[J]. 现代泌尿外科杂志, 2022, 27(6): 494-498. DOI: 10.3969/j.issn.1009-8291.2022.06.010.
[17]	Sihra N, Ockrim J, Wood D. The effects of recreational ketamine cystitis on urinary tract reconstruction - a surgical challenge[J]. BJU Int, 2018, 121(3): 458-465. DOI: 10.1111/bju.14094.
[18]	Sheybaee Moghaddam F, Ghoreifi A, Djaladat H. Comparative performance of the different orthotopic urinary diversions[J]. Curr Opin Urol, 2022, 32(5): 554-560. DOI: 10.1097/MOU.0000000000001016.
[19]	Biers SM, Venn SN, Greenwell TJ. The past, present and future of augmentation cystoplasty[J]. BJU Int, 2012, 109(9): 1280-1293. DOI: 10.1111/j.1464-410X.2011.10650.x.
[20]	Almassi N, Bochner BH. Ileal conduit or orthotopic neobladder: selection and contemporary patterns of use[J]. Curr Opin Urol, 2020, 30(3): 415-420. DOI: 10.1097/MOU.0000000000000738.
[21]	Matin SF, Gill IS. Laparoscopic radical cystectomy with urinary diversion: completely intracorporeal technique[J]. J Endourol, 2002, 16(6): 335-341;discussion341. DOI: 10.1089/089277902760261338.
[22]	Sandberg JM, Hemal AK. Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion[J]. Asian J Urol, 2016, 3(3): 156-166. DOI: 10.1016/j.ajur.2016.05.004.
[23]	Porreca A, Chessa F, Romagnoli D, et al. Robot assisted radical cystectomy with totally intracorporeal urinary diversion: initial, single-surgeon's experience after a modified modular training[J]. Minerva Urol Nefrol, 2018, 70(2): 193-201. DOI: 10.23736/S0393-2249.17.02970-8.

组别	例数	日间排尿次数(±s)	夜尿次数(±s)	上尿路积水[例(%)]	膀胱壁厚度[mm，(±s)]	膀胱容量[mL，(±s)]	最大尿流率[mL/s，(±s)]
手术前	13	14.15±3.05	6.69±1.84	11（84.62）	9.23±2.05	39.62±8.60	11.39±2.43
术后第6个月	13	5.00±1.58	3.85±1.52	5（38.46）	8.08±1.44	241.92±29.41	15.85±1.68
统计值		t=11.540	t=3.933	-	t=2.044	t=-28.085	t=-6.036
P值		<0.001	<0.001	<0.001	0.063	<0.001	<0.001
组别	膀胱顺应性[mL/cmH₂O，(±s)]	储尿期最大逼尿肌压力[cmH₂O，(±s)]	残余尿量[mL，M(Q)]	泌尿系感染[例(%)]	肝功能异常[例(%)]	肾功能异常[例(%)]	VAS评分[分，(±s)]
手术前	23.15±7.82	30.31±6.81	6.0（0，9.5）	13（100）	7（53.85）	10（76.92）	9.62±2.66
术后第6个月	33.92±7.81	21.77±3.14	5.0（0，8.5）	3（23.08）	6（46.15）	5（38.46）	5.69±1.93
统计值	t=-3.513	t=4.671	Z=-1.021	-	-	-	t=4.977
P值	<0.001	<0.001	0.308	<0.001	>0.999	<0.001	<0.001

组别	例数	日间排尿次数(±s)	夜尿次数(±s)	上尿路积水[例(%)]	膀胱壁厚度[mm，(±s)]	膀胱容量[mL，(±s)]	最大尿流率[mL/s，(±s)]
手术前	13	14.15±3.05	6.69±1.84	11（84.62）	9.23±2.05	39.62±8.60	11.39±2.43
术后第6个月	13	5.00±1.58	3.85±1.52	5（38.46）	8.08±1.44	241.92±29.41	15.85±1.68
统计值		t=11.540	t=3.933	-	t=2.044	t=-28.085	t=-6.036
P值		<0.001	<0.001	<0.001	0.063	<0.001	<0.001
组别	膀胱顺应性[mL/cmH₂O，(±s)]	储尿期最大逼尿肌压力[cmH₂O，(±s)]	残余尿量[mL，M(Q)]	泌尿系感染[例(%)]	肝功能异常[例(%)]	肾功能异常[例(%)]	VAS评分[分，(±s)]
手术前	23.15±7.82	30.31±6.81	6.0（0，9.5）	13（100）	7（53.85）	10（76.92）	9.62±2.66
术后第6个月	33.92±7.81	21.77±3.14	5.0（0，8.5）	3（23.08）	6（46.15）	5（38.46）	5.69±1.93
统计值	t=-3.513	t=4.671	Z=-1.021	-	-	-	t=4.977
P值	<0.001	<0.001	0.308	<0.001	>0.999	<0.001	<0.001

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