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  • Review Article
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Urological complications of illicit drug use

Nature Reviews Urology volume 11, pages 169–177 (2014)Cite this article

Subjects

Key Points

  • Urologists need to be aware of the potential urological complications of illicit drug use and obtain relevant drug histories when appropriate

  • Case–control studies have suggested an association with certain urological cancers including renal cell carcinoma (amphetamines), bladder cancer (cannabis and heroin), prostate cancer (cannabis) and nonseminomatous germ cell tumours (cannabis)

  • Ketamine cystitis is an established entity with one-quarter of users reporting lower urinary tract symptoms

  • Cocaine use is associated with a variety of sexual dysfunctions, including priapism and Fournier's gangrene

  • Increased reporting and epidemiological studies are needed to fully understand the full impact of illicit drug use on urology

Abstract

Illicit drug use is prevalent worldwide; over 24 million people are estimated to have used recreational drugs during the past month in the UK and USA alone. Illicit drug use can result in a wide spectrum of potential medical complications that include many urological manifestations. To ensure optimal care and treatment, urologists need to be cognizant of these complications in their patients, particularly among youths. Ketamine uropathy is thought to affect over one-quarter of ketamine users and can lead to severe lower urinary tract symptoms, as well as upper tract obstruction. Cannabis use has been associated with an increased risk of bladder cancer, prostate cancer and nonseminomatous germ cell tumours in case–control studies. Fournier's gangrene has been reported following injection of heroin and cocaine into the penis. Excessive use of cough medicines can lead to the development of radiolucent stones composed of ephedrine, pseudoephedrine and guaifenesin. As the current evidence is mostly limited to case reports and case series, future epidemiological studies are needed to fully address this issue.

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  1. Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel Street, Vancouver, V5Z 1M9, BC, Canada

    Sean C. Skeldon & S. Larry Goldenberg

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S.C.S. researched data for the article. Both authors contributed to discussion of content, writing and reviewing the manuscript before submission.

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Skeldon, S., Goldenberg, S. Urological complications of illicit drug use. Nat Rev Urol 11, 169–177 (2014). https://doi.org/10.1038/nrurol.2014.22

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