Children as young as 13 are being treated for serious bladder problems linked to non-prescribed ketamine use, highlighting a potentially severe consequence of repeated exposure to the drug.

Doctors at Alder Hey Children's NHS Foundation Trust in Liverpool analysed the first 60 patients referred to its specialist ketamine-induced uropathy clinic. The patients had an average age of 14, with ages ranging from 13 to 15. Ketamine use had often started at around age 13.

The clinic, established in 2025, was created in response to increasing referrals of under-16s with ketamine-induced uropathy, commonly known as 'ketamine bladder'.

What Is 'Ketamine Bladder'?

Ketamine-induced uropathy is a condition in which repeated ketamine exposure damages the urinary system, particularly the bladder. Ketamine and its metabolites are eliminated through urine, and research suggests they can damage the lining of the urinary tract and trigger inflammation.

Over time, this can cause the bladder wall to become scarred and fibrotic, reducing its ability to store urine normally. Damage can also extend to the tubes connecting the kidneys to the bladder and the kidneys themselves.

Symptoms can include needing to urinate frequently, sudden urges to urinate, urinary incontinence, pain or burning while urinating, and blood in the urine. Bladder pain can also become severe.

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Why Ketamine Bladder Can Be Difficult To Recognise

The early symptoms of ketamine-induced uropathy can resemble those of more common urinary problems, such as a urinary tract infection. Frequent urination, an urgent need to pass urine, pain while urinating, and blood in the urine can all occur with other conditions.

This can make it difficult to recognise the connection with ketamine use, particularly when a person does not disclose drug use to a healthcare professional.

Healthcare professionals may use urine tests, imaging, and other investigations to assess the urinary tract and determine whether the bladder or kidneys have been affected.

How Serious Can the Damage Become?

Ketamine-related bladder damage can become debilitating and, in advanced cases, irreversible.

Harriet Corbett, a consultant paediatric urologist at Alder Hey, said the condition can cause ulceration and fibrosis of the bladder wall. Some young people may develop chronic bladder pain and incontinence, while the most severe cases can require major surgery or dialysis.

A review published in 2026 found that more than one-quarter of ketamine users may experience at least one bothersome urinary symptom, with heavier and longer-term use associated with a greater risk of potentially irreversible damage.

Who Is Being Affected?

The Alder Hey analysis also identified wider social and health factors among the 60 young people treated.

Around two-thirds of the patients were girls, while 72% had experienced emotional trauma during childhood. One in five had experience of the care system, and 16 of the 60 had autism, ADHD or both. About half also reported using other substances alongside ketamine.

The findings do not mean these experiences cause ketamine use or bladder damage. Instead, researchers said they highlight the need for services that consider the broader circumstances surrounding young people's substance use.

Can Ketamine Bladder Damage Be Treated?

Stopping ketamine use is considered the most important part of treatment. Some symptoms may improve after stopping, particularly when the condition is identified early, although established damage may not fully reverse.

Treatment can also include medicines to control bladder symptoms, pain management and procedures such as bladder instillations or injections of botulinum toxin. Severe cases may require reconstructive surgery.

Anyone experiencing blood in the urine, severe bladder pain, urinary incontinence, or a sudden change in urinary habits after ketamine use should seek medical attention. Early assessment may help prevent further damage and provide an opportunity to address ketamine dependence before complications become permanent.

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