Liverpool hospital sees rise in children treated for ketamine bladder damage

Alder Hey children's hospital in Liverpool has opened the UK's first clinic dedicated to young people with urological problems linked to ketamine use. The clinic was set up in response to a rise in cases of what doctors call "ketamine bladder", a painful condition caused by damage to the bladder, urinary tract and kidneys.

Sustained ketamine use can cause serious health problems, because the drug and its breakdown products remain in the bladder for a long time, damaging its tissue and muscle. Symptoms include frequent urination, loss of bladder control and blood in the urine. Some of the young people treated at the clinic use incontinence pads or urinate into buckets beside their bed at night.

A first analysis of the clinic's patients, carried out by researchers from Alder Hey and Lancaster University and published in the journal Archives of Disease in Childhood, examined the first 60 cases. The average age was 14, ranging from 13 to 15. About two-thirds of patients were girls, and a similar proportion lived in the most deprived areas. Sixteen of the 60 young people had autism, ADHD, or both. One in five had experience of the care system, and almost three-quarters had experienced emotional trauma during childhood.

A condition that can become irreversible

Harriet Corbett, a consultant paediatric urologist at Alder Hey, said the damage caused by ketamine could be devastating. She said the drug can affect the bladder wall, causing ulceration and fibrosis, with effects that in some cases are irreversible. Young people can suffer chronic bladder pain and incontinence and, in the most severe cases, may need major surgery or dialysis.

Corbett added that doctors were receiving a growing number of referrals for children with bladder symptoms linked to non-prescribed ketamine use. According to Corbett, understanding the personal background of young patients - their age, where they live, their life experience - helps build a clearer picture of who is affected and how best to support them.

Rachel Isba, a consultant in paediatric public health at Alder Hey and professor emerita of children and young people's health at Lancaster University, said ketamine use never happens in isolation, and that analysing the data helps identify the factors linked to the development of serious health problems in young people. The clinic takes what it calls a "non-judgmental" approach: the aim, Isba said, is to give young people a safe space to talk about their lives and work together on a plan to stop using ketamine and prevent further harm.