Abstract

Ketamine-induced cystopathy is a severe complication of chronic recreational ketamine use, leading to bladder fibrosis and renal impairment. We report a 35-year-old man with long-term intranasal ketamine abuse who presented with severe lower urinary tract symptoms, hydronephrosis, and chronic kidney disease. Cystoscopy and histology revealed a fibrotic, inflamed bladder requiring reconstructive surgery with an ileal neobladder. This case highlights an advanced presentation of ketamine uropathy and emphasizes the need for early recognition to prevent irreversible urinary tract and renal damage.