Sexual and bladder dysfunction in male ketamine abusers: A large-scale questionnaire study

Purpose To evaluate the prevalence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in the illicit male ketamine abusers (KA). Materials and methods The male street KAs caught by policemen and patients visiting urologic clinics were invited to answer a structured questionnaire including demographic data, illicit drug use related details (duration, frequency, dosage and abstinence status), international prostate symptoms score (IPSS), interstitial cystitis symptoms and problem index (ICSI and ICPI) and International index of erectile function (IIEF-5). Erectile dysfunction was defined as IIEF-5 <= 21. Results Finally, we included 1056 participants (993 street, 63 hospital KAs) with a mean age of 27.4 +/- 6.2 years. ED presented in 30.8% of all KAs. and Hospital KAs were more subject to having ED than street KAs (69.6% vs. 28.0%, p<0.01). Multi-variate analysis revealed that risk factor for male ED were age >= 30 years (OR = 1.765). Subgroup analysis on male street KAs disclosed that abstinence >= 3 months is a protective factor for ED. Lower urinary tract symptoms (ICSI+ICPI >= 12) was prevalent in KAs and multivariate analysis disclosed that significant risk factors for LUTS (ICSI+ICPI >= 12) were age >= 30 years, duration >= 24 months and co-use of other illicit drugs. Conclusions Male ED and LUTS were frequently observed in the ketamine abusers. We suggested that street ketamine abuse should be considered in young men presented with ED and LUTS in the clinics.