Does ketamine shrink your bladder? How one woman ended up going to the toilet 50+ times a day

Ketamine has long existed in two sharply different worlds: an essential anaesthetic used in hospitals and veterinary care, and a recreational substance whose hallucinogenic effects fuel its popularity on the club scene.

But as its use grows among young adults, doctors are warning of severe bladder complications once seen almost exclusively in much older patients. One young woman’s experience, going to the toilet more than 50 times a day, has become a stark illustration of what chronic ketamine use can do.

What Ketamine is, and why the risks are often misunderstood

Although it is commonly labelled a “horse tranquilliser”, ketamine has been used in human medicine since the 1960s because of its pain-relieving, sedative and anaesthetic properties. First synthesised in 1964, it became the drug of choice on the battlefield and was used extensively during the Vietnam War because it does not suppress breathing or lower heart rate, while still providing analgesia and amnesia.Today, it remains widely used for anaesthesia, sedation and pain relief, and continues to be a standard drug in veterinary medicine. Its dissociative and hallucinogenic effects, however, have also made it a common “party drug”, sold as a crystalline powder or liquid and widely referred to on the street as Special K. Reports indicate that doctors are now seeing young users with urinary complications normally associated with older patients, suggesting a shift in the demographic affected by long-term bladder damage.

“I was nipping to the loo 50 plus times a day”

According to Ladbible, Paige Collins, a 25-year-old from Hampshire, spent £1,000 a month on ketamine during her years of addiction. She first tried it at 19 on a night out, telling the outlet:“I was 19 when I first tried ketamine. My friend asked me to sort some for a rave we were going to and it started from there.”Part of ketamine’s presence in rave and underground party scenes comes from the dissociative, dream-like high it produces. Reports describe users experiencing a sense of detachment from their surroundings, altered perception of time and space, and, at higher doses, entering what’s known as the K-hole, an intense state often likened to an out-of-body or near-complete sensory dissociation.

For some, this creates a feeling of serenity or escapism, which is why the drug became embedded in club culture despite its medical origins and significant risks. What began as an occasional indulgence escalated into a daily habit. She explained:“It started as a once-in-a-blue-moon thing then it was a weekend thing then [it] started picking up during covid to week days and then every day. Initially I really enjoyed it. It took me three years to realise I was addicted.” Her use eventually reached five to 10 grams a day, costing £150 to £250 a week. The physical consequences soon appeared. Paige began experiencing excruciating pain, and a jelly-like substance when she urinated, an early sign of ketamine-induced bladder changes. As symptoms escalated, she described losing the ability to live normally, saying:“I was nipping to the loo 50 plus times a day. It was ruining my life. I couldn't go out for four or five months of 2023, I didn't leave the house.” A scan later revealed the extent of the damage: her bladder had contracted so severely that it could hold only 30ml of urine, roughly the volume of a shot glass. For comparison, the NHS states that a healthy bladder should hold 400–600ml. Paige has been told the damage is irreversible, though she is undergoing bladder instillation treatment to stretch the bladder and ease the pain. She said:“There's nothing I can do to make my bladder the way it once was… I just want to raise awareness as I know the physical and emotional pain this has caused me and I wouldn't wish it on my worst enemy.” Another young woman, Beth, also recounted her experience to the BBC, saying:“I can't walk 50 metres without either needing to sit down or needing to run to the toilet.”

How Ketamine affects the bladder

Research indicates that 26–30% of ketamine users experience at least one urinary symptom, and published findings suggest that using the drug three or more times a week over a two-year period can alter bladder function. In some cases, individuals begin developing severe urological problems within months of frequent use. Among the symptoms described, bladder pain is often the most debilitating, sometimes becoming so overwhelming that users take more ketamine in an attempt to ease the discomfort, a cycle that ultimately worsens the damage.

Reports also highlight patients presenting with reduced bladder capacity, thickened bladder walls, and hydronephrosis, a swelling of the kidney’s renal pelvis caused by urine building up due to impaired bladder function.In simple terms, chronic ketamine use damages the bladder lining and can cause it to shrink. This may lead to constant urges to urinate, infections, bleeding, blockages, and even incontinence. Doctors say the drug and its metabolites irritate the bladder lining, leading to inflammation, swelling and increased sensitivity. Over time, ketamine can cause:

The medical community refers to this cluster of symptoms as ketamine bladder syndrome, also known as:

A 2024 case report in the Journal of Urological Surgery found that ketamine’s effects may extend beyond the bladder to the ureters and kidneys, adding further concerns. Dr Mohammed Belal of the British Association of Urological Surgeons told the BBC:“Ketamine destroys the lining of the bladder, and that can have very serious consequences. We've noticed lots of young patients with severe bladder problems that we would not expect to see until patients are much older.”

Symptoms of Ketamine Bladder, and why early signs matter

For Paige, these symptoms arrived rapidly and soon dominated her routine, resulting in more than 50 toilet visits a day and prolonged periods where she could not leave her home.Experts warn that when early urinary changes are ignored, ongoing ketamine use can push the bladder towards irreversible scarring and, in the most advanced cases, leave young adults requiring reconstructive surgery that was once considered rare for their age group. Research referenced by Urology & Continence Care Today highlights how these risks build over time: using ketamine three or more times a week for around two years has been associated with measurable changes in bladder function, though the severity can differ sharply between individuals. The evidence suggests a clear dose–response pattern, the heavier and longer the use, the greater the likelihood of harm, with estimates indicating that up to 30% of recreational users develop bladder symptoms linked directly to their consumption.

Will the bladder heal if someone stops using Ketamine?

Whether the bladder can recover after ketamine use depends largely on how early the damage is identified and how quickly the drug is stopped. Once ketamine irritation begins, removing the cause as soon as possible gives the bladder its best chance to heal. If the inflammation is caught early, recovery is more likely; however, if ketamine has already caused scarring, nerve damage or long-term shrinking of the bladder, the effects may become permanent. Stopping the drug is the cornerstone of every treatment plan, yet medical professionals note that this is not always straightforward, even when the user understands the risks. Because the severity of symptoms is closely tied to both dose and duration of use, early diagnosis and prompt medical intervention are vital to prevent further injury.Research indicates that recovery is possible: in around 51% of cases, symptoms improve and bladder function either significantly recovers or returns to normal once ketamine use ceases. Anyone experiencing persistent urinary pain, sudden frequency, visible blood in urine or any other unusual symptoms linked to ketamine should seek medical advice immediately. Health experts stress that honest disclosure about drug use is crucial, as early transparency gives clinicians the best chance to manage the condition and prevent further, potentially irreversible damage.