humulene and Urinary-Incontinence

To describe marijuana's clinical role for urologic symptoms.. Studies related to marijuana, voiding dysfunction, lower urinary tract symptoms (LUTS), and pain through January 2019 from PubMed were evaluated for relevance and quality.. Forty-eight studies were reviewed. Cannabinoids have mixed efficacy for neurogenic LUTS and little evidence for non-neurogenic LUTS, chronic non-cancer-related and perioperative pain. For cancer-related pain, high-level studies demonstrate cannabinoids are well-tolerated with unclear benefit.. Cannabinoids appear well-tolerated in the short-term, but their efficacy and long-term impact is unproven and unknown in urologic discomfort. Cannabinoids for urologic symptoms should be further explored with well-designed randomized controlled trials.

Topics: Cancer Pain; Cannabidiol; Cannabinoid Receptor Agonists; Cannabinoids; Cannabis; Chronic Pain; Cystitis, Interstitial; Dronabinol; Drug Combinations; Humans; Lower Urinary Tract Symptoms; Male; Medical Marijuana; Multiple Sclerosis; Pain, Procedural; Pelvic Pain; Urinary Incontinence

In this study, we investigated the association between recent cannabis use and urinary incontinence(UI) among women using the 2009-2018 National Health and Nutrition Examination Survey.. A total of 7889 women aged 20 years and older were included in the study. Respondents were dichotomized as recent users or non-users if they had used or not used cannabis in the past 30 days, respectively. Urinary incontinence (UI) was ascertained by self-report. Multivariable logistic regression models were used to adjust for sociodemographic and health-related covariates.. Among 7889 women, 12.1% (n = 955) of subjects reported recent cannabis use. In the adjusted analysis, recent users were more likely than non-users to report stress, urge and mixed incontinence (OR 1.31, 95% CI 1.12-1.53, p < 0.001; OR 1.40, 95% CI 1.18-1.66, p < 0.001; and OR 1.29, 95% CI 1.12-1.53, p = 0.018). And, the association becomes more significant among heavy users (≥ 20 of the past 30 days) (SUI: OR 1.63, 95% CI 1.26-2.09, p < 0.001; UUI: OR 1.72, 95% CI 1.32-2.24, p < 0.001; and MUI: OR 1.64, 95% CI 1.20-2.25, p = 0.0019).. Recent cannabis use was associated with an increased likelihood of stress, urge and mixed incontinence in women.

Topics: Cannabis; Female; Humans; Nutrition Surveys; Surveys and Questionnaires; Urinary Incontinence; Urinary Incontinence, Stress; Urinary Incontinence, Urge

To evaluate the effect of a Cannabis sativa extract enriched in cannabidiol (CBD) botanic drug substance (BDS) and pure CBD, on bladder contractility in vitro. Cannabis based-medicines, including CBD-enriched extracts, have been shown to reduce urinary urgency, incontinence episodes, frequency, and nocturia in patients with multiple sclerosis.. Strips were cut from male Wistar rats and the human bladder body and placed in organ baths containing Krebs solution. Contractions were induced by electrical field stimulation, acetylcholine, KCl, and α,β-methylene adenosine triphosphate.. CBD BDS significantly reduced the contractions induced by acetylcholine, but not those induced with electrical field stimulation, KCl, or α,β-methylene adenosine triphosphate in the isolated rat bladder. The inhibitory effect of CBD BDS was not significantly modified by the cannabinoid or opioid receptor antagonists or by modulators of calcium levels, but it was increased by ruthenium red and capsazepine, 2 transient receptor potential vanilloid type-1 blockers. In humans, CBD BDS and pure CBD significantly reduced acetylcholine-induced contractions, an effect that was not changed by the transient receptor potential vanilloid type-1 blockers.. Our data have suggested that CBD BDS reduces cholinergic-mediated contractility and that this effect is modulated by transient receptor potential vanilloid type-1 in rats but not in humans. CBD is the chemical ingredient of CBD BDS responsible for such activity. If confirmed in vivo, such results could provide a pharmacologic basis to explain, at least in part, the efficacy of Cannabis medicines in reducing incontinence episodes in patients with multiple sclerosis.

Topics: Acetylcholine; Animals; Cannabidiol; Cannabis; Cholinergic Agonists; Humans; In Vitro Techniques; Male; Multiple Sclerosis; Muscle Contraction; Muscle, Smooth; Plant Extracts; Rats; Rats, Wistar; Urinary Bladder; Urinary Incontinence

The majority of patients with multiple sclerosis (MS) develop troublesome lower urinary tract symptoms (LUTS). Anecdotal reports suggest that cannabis may alleviate LUTS, and cannabinoid receptors in the bladder and nervous system are potential pharmacological targets. In an open trial we evaluated the safety, tolerability, dose range, and efficacy of two whole-plant extracts of Cannabis sativa in patients with advanced MS and refractory LUTS. Patients took extracts containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD; 2.5 mg of each per spray) for eight weeks followed by THC-only (2.5 mg THC per spray) for a further eight weeks, and then into a long-term extension. Assessments included urinary frequency and volume charts, incontinence pad weights, cystometry and visual analogue scales for secondary troublesome symptoms. Twenty-one patients were recruited and data from 15 were evaluated. Urinary urgency, the number and volume of incontinence episodes, frequency and nocturia all decreased significantly following treatment (P <0.05, Wilcoxon's signed rank test). However, daily total voided, catheterized and urinary incontinence pad weights also decreased significantly on both extracts. Patient self-assessment of pain, spasticity and quality of sleep improved significantly (P <0.05, Wilcoxon's signed rank test) with pain improvement continuing up to median of 35 weeks. There were few troublesome side effects, suggesting that cannabis-based medicinal extracts are a safe and effective treatment for urinary and other problems in patients with advanced MS.

Topics: Adult; Cannabidiol; Cannabis; Dose-Response Relationship, Drug; Dronabinol; Drug Administration Schedule; Follow-Up Studies; Humans; Medical Records; Middle Aged; Multiple Sclerosis; Pilot Projects; Plant Extracts; Sensation; Surveys and Questionnaires; Treatment Outcome; Urinary Bladder; Urinary Bladder, Neurogenic; Urinary Incontinence; Urination; Urodynamics