ABSTRACT
Objective To investigate the effects of cystectasia with sodium hyaluronate solution on ketamine related cystitis.Methods From June 2008 to October 2012,29 patients with ketamine related cystitis were analyzed,among which 27 were males and 2 were females.Their age ranged from 18 to 36 years old with a mean age of 25.All of them had frequency,urgency,urodynia and suprapubic pain.Voiding volume ranged from 10 to 160 ml and the interval duration ranged from 10 to 60 min.The test of ketamine in urine was positive.Patients were divided into four groups according to the treatment modality,namely the surgical treatment group (group A,n =11),surgery followed by addiction relapse group (group B,n =7),drug treatment group (group C,n =6) and non-drug treatment group (group D,n =5).Patients in group A and B underwent cystectasia with sodium hyaluronate solution under combined spinal-epidural anesthesia,and patients in group B were reported of addiction relapse within 2 weeks after cystectasia treatment.Patients in group C were free of the addiction to ketamine,while those in group D still rely on the ketamine.The average urine volume,OABSS and PUF scores were recorded 2 weeks and 4 weeks after the treatment.Results Two weeks after cystectasia,the average urine volums in group A and B were (107.7±39.6) ml and (95.0±35.5) ml respectively,which was larger than that in group D (42.0±13.5) ml,plus the volume in group A was larger than that in group C (63.3± 16.3) ml.The aforementioned differences were considered statistically significant (P＜0.05).As for OABSS and PUF scores,scores in group A [(6.0±2.6),(14.8± 4.2)] were lower than those in group C [(9.5±2.4),(22.5±2.2)].Furthermore,scores in group B [(9.0±2.4),(19.57±2.7)] were lower than those in group D [(12.2±1.9),(26.4±3.5)] (P＜0.05).Four weeks later,the average urine volume,OABSS and PUF scores in group A [(106.4±37.5) ml,(5.6± 2.5),(13.5±4.0)] and group C[(113.3±27.3) ml,(6.3±2.2),(14.5±2.7)] were significantly different from those in group B [(52.1±21.6) ml,(11.1±1.3),(26.4±2.8)] and group D [(40.0±13.7)ml,(12.0±1.6),(26.6±3.6)] (P＜0.05).While,no obvious distinction was observed between group A and group C,group B and group D in terms of average urine volume,OABSS and PUF scores at 4 weeks postoperatively (P＞0.05).Conclusions Cystectasia can efficiently alleviate lower urinary tract syndromes in patients with ketamine related cystitis.