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Ulcerative cystitis with an easily bleeding mucosa is a common cystoscopic finding. Microscopically, the urothelium is denuded and is infiltrated by inflammatory cells, such as mast cells and eosinophils. The pathogenesis of ketamine\u2010related cystitis is complicated and involves many different pathways. Past evidence suggests a direct toxic effect, bladder barrier dysfunction, neurogenic inflammation, immunoglobulin\u2010E\u2010mediated inflammation, overexpression of carcinogenic genes, abnormal apoptosis and nitric oxide synthase\u2010mediated inflammation contribute to the pathogenesis of ketamine\u2010related cystitis. The first step to managing ketamine\u2010related cystitis is always asking patients to cease ketamine. Medical treatment might be helpful in patients with early ketamine\u2010related cystitis and abstinence from ketamine. Several case studies showed that the intravesical installation of hyaluronic acid and intravesical injection of botulinum toxin type A were effective for symptom relief in selected patients. For patients with irreversible pathological change, such as contracted bladder, augmentation enterocystoplasty might be the only solution to increase bladder capacity and relieve intractable bladder pain.<\/jats:p>","DOI":"10.1111\/iju.12841","type":"journal-article","created":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T03:24:36Z","timestamp":1434684276000},"page":"816-825","source":"Crossref","is-referenced-by-count":100,"title":["Possible pathophysiology of ketamine\u2010related cystitis and associated treatment strategies"],"prefix":"10.1111","volume":"22","author":[{"given":"Jia\u2010Fong","family":"Jhang","sequence":"first","affiliation":[{"name":"Department of Urology Buddhist Tzu Chi General Hospital Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung\u2010Hsiang","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Pathology Buddhist Tzu Chi General Hospital Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hann\u2010Chorng","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Urology Buddhist Tzu Chi General Hospital Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,6,18]]},"reference":[{"key":"e_1_2_15_2_1","volume-title":"Faust's Anesthesiology Review","author":"Michael JM","year":"2015"},{"key":"e_1_2_15_3_1","volume-title":"Word Drug Report 2011","author":"Chawla S","year":"2011"},{"key":"e_1_2_15_4_1","volume-title":"Prevention of Drug Abuse Results in Young Adult in Taiwan","author":"Chang FM","year":"2012"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2007.01.038"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/53.8.805"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/77.2.203"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425250903505108"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/15287390590967522"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/29.5.376"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/25.7.583"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11028.x"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1747-597X-9-39"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndtplus\/sfn054"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22477"},{"key":"e_1_2_15_16_1","first-page":"311","article-title":"\u2018Street ketamine\u2019\u2010associated bladder dysfunction: a report of ten cases","volume":"3","author":"Chu PS","year":"2007","journal-title":"Hong Kong Med. 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