most people who use ketamine regularly don’t know about ketamine cystitis until it’s too late. by then, they’re pissing blood and can’t hold it for more than twenty minutes.

what happens

ketamine and its metabolites are toxic to the bladder lining. repeated exposure causes inflammation, ulceration, and eventually fibrosis. the bladder wall thickens. capacity shrinks. in severe cases, surgical removal is the only option.

the timeline

this isn’t a one-time-use risk. it’s cumulative. regular use over months to years causes progressive damage. but “regular” is subjective. some people show symptoms after a few months of weekend use. others take longer. there’s no safe threshold established.

what you can do

• hydrate aggressively before, during, and after. dilute those metabolites.
• don’t redose endlessly. set a limit. stick to it.
• green tea extract (EGCG) shows some protective effects in animal studies. not proven in humans, but low risk.
• if you’re pissing more frequently than usual, that’s your warning. stop. see a urologist. don’t wait.

the honest part

telling people “just don’t do it” doesn’t work. you already know that. so if you’re going to use, at least know what’s at stake and take the basic precautions. your future self’s bladder depends on it.