This manuscript was written before the review paper on ketamine abuse uropathy. It was after writing this paper that the authors felt that there is the need to review this new entity to see what has been reported globally on this new clinical entity. The review paper is an update on the subject and some contents in this paper have been included in the review. any one who reads the review would not miis much by not reading the case report which was published earlier. Perhaps some repeatition may reinforce what has previously been read.  We all have different view points. The reviewer is entitled to his opinion. Others have different view points.