Relationship between sexual and bladder dysfunction in women consuming ketamine

Background Although ketamine has become the second most popular recreational drug in Taiwan, there have been very few reported studies that investigated female sexual dysfunction (FSD) in ketamine abusers (KAs). Aims We sought to compare the difference between street and hospital KAs and explored the risk factors for FSD and lower urinary tract symptoms (LUTS) in KAs. Methods In this cross-sectional study, female KAs aged 18 years or older were invited to complete anonymous questionnaires during an educational course provided by the departments of substance control and prevention of the local government or under the instruction of medical providers at a urology clinic. Data were reported as median (IQR) and OR and analyzed with commercial statistical software. Outcomes Key outcome measurements were illicit drug use history, FSD symptoms, and LUTS severity. Results We included 139 women (104 street and 35 hospital KAs) with a median age of 27.08 years. FSD was reported in 76% of all the participants (street vs hospital KAs, 68% vs 97%, P < 0.001). LUTS (Interstitial Cystitis Symptom Index [ICSI] + Interstitial Cystitis Problem Index [ICPI] & GE;12) was found to be a significant risk factor for FSD in KAs. More hospital KAs (71%) reported experiencing LUTS (ICSI + ICPI & GE;12) than street KAs (8%, P < 0.001). Longer duration of ketamine use (& GE;36 months) and mild to severe psychological symptoms (5-item Brief Symptom Rating Scale [BSRS-5] & GE;6) were significant risk factors for LUTS. Clinical Implications Sexual problems among KAs should not be overlooked since more severe sexual dysfunction was observed in patients reporting LUTS. Strengths and Limitations To our knowledge, the present study is the largest study using validated and reliable questionnaires to examine FSD in KAs and also the first study to include street KAs. The main limitation of this study is using self-report questionnaires as they are subjective and susceptible to human errors and recall biases. Conclusions Women who abused ketamine and reported experiencing LUTS were found to be more likely to have FSD.