Children as young as 13 in UK referred to ketamine bladder clinic amid surge in urology cases

Children as young as 13 in the UK have been referred to a specialist clinic for a “devastating” bladder condition linked to sustained use of ketamine.

Medics at Alder Hey children’s hospital in Liverpool opened the first ketamine clinic in the UK for young people amid a surge in urology problems linked to addiction of the drug.

Now analysis of the first patients to use the service shows some are as young as 13, with most being girls and most living in deprived areas.

Excessive use of ketamine can cause serious health problems as the drug and its breakdown products sit in the bladder for a long time, where they can damage the lining and muscle tissue.

Ketamine-induced uropathy – also known as ketamine bladder – is a severe and painful condition caused by the drug damaging the bladder, urinary tubes and kidneys. Symptoms include frequent urination, loss of bladder control and blood in the urine.

Some of the children affected are using incontinence pads and urinating in buckets next to their bed at night due to bladder problems caused by addiction to ketamine.

“The damage caused by ketamine can be devastating,” said Harriet Corbett, a consultant paediatric urologist at Alder Hey children’s NHS foundation trust.

“It can affect the bladder wall, causing ulceration and fibrosis, and the effects can be irreversible. Young people can experience chronic bladder pain and incontinence and, in the most severe cases, may go on to require major surgery or dialysis.”

Doctors were being referred to a rising number of children with bladder symptoms caused by non-prescribed ketamine use, Corbett added.

“What this first year of analysis has highlighted is the importance of understanding the young person behind the diagnosis.”

Analysis of the first patients to use the service shows some are as young as 13, with most being girls and most living in deprived areas.

“By looking at factors such as age, where they live, their background and their life experiences, we can start to build a much clearer picture of who is being affected and how we can best support them.

“This problem is preventable. Understanding more about the young people who are presenting to us is an important step towards preventing further harm,” Corbett said.

Analysis of the clinic’s first 60 patients by researchers at Alder Hey and Lancaster University showed their average age was 14, ranging from 13 to 15.

About two-thirds were girls, and roughly the same proportion lived in the most deprived areas, according to the analysis published in the Archives of Disease in Childhood medical journal.

Of the 60, 16 had autism or ADHD, or both. One in five had experience of the care system. Almost three-quarters (72%) had experienced emotional trauma during childhood.

Prof Rachel Isba, a consultant in paediatric public health medicine at Alder Hey and professor emerita of children and young people’s health at Lancaster University, said: “One of the most important things about this work is that we are trying to understand the wider picture.

“Ketamine use does not happen in isolation, and our analysis is helping us explore the different factors that may be associated with young people developing serious health problems.”

The clinic at Alder Hey takes a “non-judgmental” approach, Isba said. “We want to give young people a safe space to talk about what is happening in their lives and work with them to develop a plan to stop using ketamine and prevent further damage.”