Top

Current Bladder Dysfunction Reports

Published in:

01-09-2021 | Cystitis | Reconstructed Bladder Function & Dysfunction (M Kaufman, Section Editor)

Cannabinoid Therapy in Female Pelvic Medicine and Reconstructive Surgery: Current Evidence and Future Directions

Authors: Jocelyn Stairs, Finlay Maguire, Christian Lehmann, Ashley Cox

Published in: Current Bladder Dysfunction Reports | Issue 3/2021

Abstract

Purpose of Review

In this review, we examine the current literature regarding the use of cannabinoids in several areas of female pelvic medicine and reconstructive surgery (FPMRS) including overactive bladder, interstitial cystitis/bladder pain syndrome, and chronic pelvic pain.

Recent Findings

Animal models support the role of the endocannabinoid system in the pathophysiology of these disorders and several drug targets have been identified. However, clinical studies remain limited. Palmitoylethanolamine (PEA) is emerging as a possible therapy for pain in this context.

Summary

There is currently insufficient evidence to support cannabinoid therapy in disorders related to FPMRS and many of the clinical studies to date have limitations in terms of size and study design.

Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6. https://doi.org/10.1001/jama.300.11.1311.CrossRefPubMedPubMedCentral

Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. Women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278–83. https://doi.org/10.1097/AOG.0b013e3181c2ce96.CrossRefPubMed

Sung VW, Washington B, Raker CA. Costs of ambulatory care related to female pelvic floor disorders in the United States. Am J Obstet Gynecol. 2010;202(5):483.e1–4. https://doi.org/10.1016/j.ajog.2010.01.015.CrossRef

Sexton CC, Notte SM, Maroulis C, Dmochowski RR, Cardozo L, Subramanian D, et al. Persistence and adherence in the treatment of overactive bladder syndrome with anticholinergic therapy: a systematic review of the literature. Int J Clin Pract. 2011;65(5):567–85. https://doi.org/10.1111/j.1742-1241.2010.02626.x.CrossRefPubMed

Thomas T. Clinical Consensus Statement: Association of anticholinergic medication use and cognition in women with overactive bladder. Female Pelvic Med Reconstr Surg. 2021;27(2):69–71. https://doi.org/10.1097/SPV.0000000000001008.CrossRef

Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU Guideline. J Urol. 2012;188(6S):2455–63. https://doi.org/10.1016/j.juro.2012.09.079.CrossRefPubMed

Yoshimura N, Chancellor MB. Current and future pharmacological treatment for overactive bladder. J Urol. 2002;168(5):1897–913. https://doi.org/10.1016/S0022-5347(05)64261-9.CrossRefPubMed

Han BH, Palamar JJ. Trends in cannabis use among older adults in the United States, 2015-2018. JAMA Intern Med. 2020;180(4):609–11. https://doi.org/10.1001/jamainternmed.2019.7517.CrossRefPubMedPubMedCentral

Hasin DS, Shmulewitz D, Sarvet AL. Time trends in US cannabis use and cannabis use disorders overall and by sociodemographic subgroups: a narrative review and new findings. Am J Drug Alcohol Abuse. 2019;45(6):623–43. https://doi.org/10.1080/00952990.2019.1569668.CrossRefPubMedPubMedCentral

10.

Rotermann M. Analysis of trends in the prevalence of cannabis use and related metrics in Canada. Health Rep. 2019;30(6):3–13. https://doi.org/10.25318/82-003-x201900600001-eng.CrossRefPubMed

11.

Meng H, Deshpande A. Cannabinoids in chronic non-cancer pain medicine: moving from the bench to the bedside. BJA Educ. 2020;20(9):305–11. https://doi.org/10.1016/j.bjae.2020.05.002.CrossRefPubMed

12.

Freeman RM, Adekanmi O, Waterfield MR, Waterfield AE, Wright D, Zajicek J. The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS). Int Urogynecol J. 2006;17(6):636–41. https://doi.org/10.1007/s00192-006-0086-x.CrossRef

13.

Kavia R, De Ridder D, Constantinescu C, Stott C, Fowler C. Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosis. Mult Scler J. 2010;16(11):1349–59. https://doi.org/10.1177/1352458510378020.CrossRef

14.

Brady CM, DasGupta R, Dalton C, Wiseman OJ, Berkley KJ, Fowler CJ. An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis. Mult Scler. 2004;10(4):425–33. https://doi.org/10.1191/1352458504ms1063oa.CrossRefPubMed

15.

Maniscalco GT, Aponte R, Bruzzese D, Guarcello G, Manzo V, Napolitano M, et al. THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study. Neurol Sci. 2018;39(1):97–102. https://doi.org/10.1007/s10072-017-3148-6.CrossRefPubMed

16.

Pertwee RG. Cannabinoid pharmacology: the first 66 years. Br J Pharmacol. 2006;147 Suppl 1(Suppl 1):S163–71. https://doi.org/10.1038/sj.bjp.0706406.CrossRefPubMed

17.

Pertwee RG. Endocannabinoids and their pharmacological actions. Handb Exp Pharmacol. 2015;231:1–37. https://doi.org/10.1007/978-3-319-20825-1_1.CrossRefPubMed

18.

Johnson SA, Rodriguez D, Allred K. A systematic review of essential oils and the endocannabinoid system: a connection worthy of further exploration. Evid Based Complement Altern Med. 2020;2020:8035301–13. https://doi.org/10.1155/2020/8035301.CrossRef

19.

Fraguas-Sánchez AI, Torres-Suárez AI. Medical use of cannabinoids. Drugs. 2018;78(16):1665–703. https://doi.org/10.1007/s40265-018-0996-1.CrossRefPubMed

20.

Hedlund P, Gratzke C. The endocannabinoid system — a target for the treatment of LUTS? Nat Rev Urol. 2016;13(8):463–70. https://doi.org/10.1038/nrurol.2016.110.CrossRefPubMed

21.

Katchan V, David P, Shoenfeld Y. Cannabinoids and autoimmune diseases: a systematic review. Autoimmun Rev. 2016;15(6):513–28. https://doi.org/10.1016/j.autrev.2016.02.008.CrossRefPubMed

22.

Turcotte C, Blanchet M-R, Laviolette M, Flamand N. The CB2 receptor and its role as a regulator of inflammation. Cell Mol Life Sci. 2016;73(23):4449–70. https://doi.org/10.1007/s00018-016-2300-4.CrossRefPubMedPubMedCentral

23.

Pacher P, Bátkai S, Kunos G. The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacol Rev. 2006;58(3):389–462. https://doi.org/10.1124/pr.58.3.2.CrossRefPubMed

24.

Gratzke C, Streng T, Park A, Christ G, Stief CG, Hedlund P, et al. Distribution and function of cannabinoid receptors 1 and 2 in the rat, monkey and human bladder. J Urol. 2009;181(4):1939–48. https://doi.org/10.1016/j.juro.2008.11.079.CrossRefPubMed

25.

Bakali E, Tincello DG. Cannabinoids and the urinary bladder. Gynecol Obstet. 2013;3(4):163. https://doi.org/10.4172/2161-0932.1000163.CrossRef

26.

Bakali E, McDonald J, Elliott RA, Lambert DG, Tincello DG. Cannabinoid receptor expression in the bladder is altered in detrusor overactivity. Int Urogynecol J. 2016;27(1):129–39. https://doi.org/10.1007/s00192-015-2802-x.CrossRefPubMed

27.

Hedlund P. Cannabinoids and the endocannabinoid system in lower urinary tract function and dysfunction. Neurourol Urodyn. 2014;33(1):46–53. https://doi.org/10.1002/nau.22442.CrossRefPubMed

28.

Guindon J, Hohmann A. The endocannabinoid system and pain. CNS Neurol Disord Drug Targets. 2009;8(6):403–21. https://doi.org/10.2174/187152709789824660.CrossRefPubMedPubMedCentral

29.

Alavi MS, Shamsizadeh A, Azhdari-Zarmehri H, Roohbakhsh A. Orphan G protein-coupled receptors: the role in CNS disorders. Biomed Pharmacother. 2018;98:222–32. https://doi.org/10.1016/j.biopha.2017.12.056.CrossRefPubMed

30.

Bakali E, Elliott RA, Taylor AH, Lambert DG, Willets JM, Tincello DG. Human urothelial cell lines as potential models for studying cannabinoid and excitatory receptor interactions in the urinary bladder. Naunyn Schmiedeberg's Arch Pharmacol. 2014;387(6):581–9. https://doi.org/10.1007/s00210-014-0973-5.CrossRef

31.

Dinis P. Anandamide-evoked activation of vanilloid receptor 1 contributes to the development of bladder hyperreflexia and nociceptive transmission to spinal dorsal horn neurons in cystitis. J Neurosci. 2004;24(50):11253–63. https://doi.org/10.1523/JNEUROSCI.2657-04.2004.CrossRefPubMedPubMedCentral

32.

Pessina F, Capasso R, Borrelli F, Aveta T, Buono L, Valacchi G, et al. Protective effect of palmitoylethanolamide in a rat model of cystitis. J Urol. 2015;193(4):1401–8. https://doi.org/10.1016/j.juro.2014.11.083.CrossRefPubMed

33.

Cadas H, di Tomaso E, Piomelli D. Occurrence and biosynthesis of endogenous cannabinoid precursor, N-arachidonoyl phosphatidylethanolamine, in rat brain. J Neurosci. 1997;17(4):1226–42. https://doi.org/10.1523/JNEUROSCI.17-04-01226.1997.CrossRefPubMedPubMedCentral

34.

Murataeva N, Straiker A, Mackie K. Parsing the players: 2-arachidonoylglycerol synthesis and degradation in the CNS. Br J Pharmacol. 2014;171(6):1379–91. https://doi.org/10.1111/bph.12411.CrossRefPubMedPubMedCentral

35.

Schreiber A, Strittmatter F, Rutz B, Hennenberg M, Stief C, Gratzke C. Expression of monoacylglycerase (MAGL) in the human lower urinary tract: a new target for intervention into the endocannabinoid system? Eur Urol Suppl. 2014;13(1):e369. https://doi.org/10.1016/S1569-9056(14)60364-X.CrossRef

36.

Bakali E, Elliott RA, Taylor AH, Willets J, Konje JC, Tincello DG. Distribution and function of the endocannabinoid system in the rat and human bladder. Int Urogynecol J. 2013;24(5):855–63. https://doi.org/10.1007/s00192-012-1954-1.CrossRefPubMed

37.

Füllhase C, Russo A, Castiglione F, Benigni F, Campeau L, Montorsi F, et al. Spinal cord FAAH in normal micturition control and bladder overactivity in awake rats. J Urol. 2013;189(6):2364–70. https://doi.org/10.1016/j.juro.2012.11.165.CrossRefPubMed

38.

Smart D, Jonsson K-O, Fowler CJ. ‘Entourage’ effects of N-acyl ethanolamines at human vanilloid receptors. Comparison of effects upon anandamide-induced vanilloid receptor activation and upon anandamide metabolism. Br J Pharmacol. 2002;136(3):452–8. https://doi.org/10.1038/sj.bjp.0704732.CrossRefPubMedPubMedCentral

39.

Morales P, Goya P, Jagerovic N, Hernandez-Folgado L. Allosteric modulators of the CB1 cannabinoid receptor: a structural update review. Cannabis Cannabinoid Res. 2016;1(1):22–30. https://doi.org/10.1089/can.2015.0005.CrossRefPubMedPubMedCentral

40.

Morales P, Goya P, Jagerovic N. Emerging strategies targeting CB₂ cannabinoid receptor: biased agonism and allosterism. Biochem Pharmacol. 2018;157:8–17. https://doi.org/10.1016/j.bcp.2018.07.031.CrossRefPubMed

41.

Barrie N, Manolios N. The endocannabinoid system in pain and inflammation: Its relevance to rheumatic disease. Eur J Rheumatol. 2017;4(3):210–8. https://doi.org/10.5152/eurjrheum.2017.17025.CrossRefPubMedPubMedCentral

42.

Maselli DB, Camilleri M. Pharmacology, Clinical effects, and therapeutic potential of cannabinoids for gastrointestinal and liver diseases. Clin Gastroenterol Hepatol. 2020:S1542-3565(20)30504–8. https://doi.org/10.1016/j.cgh.2020.04.020.

43.

Russo EB. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br J Pharmacol. 2011;163(7):1344–64. https://doi.org/10.1111/j.1476-5381.2011.01238.x.CrossRefPubMedPubMedCentral

44.

Mitchell VA, Aslan S, Safaei R, Vaughan CW. Effect of the cannabinoid ajulemic acid on rat models of neuropathic and inflammatory pain. Neurosci Lett. 2005;382(3):231–5. https://doi.org/10.1016/j.neulet.2005.03.019.CrossRefPubMed

45.

Turcotte C, Chouinard F, Lefebvre JS, Flamand N. Regulation of inflammation by cannabinoids, the endocannabinoids 2-arachidonoyl-glycerol and arachidonoyl-ethanolamide, and their metabolites. J Leukoc Biol. 2015;97(6):1049–70. https://doi.org/10.1189/jlb.3RU0115-021R.CrossRefPubMed

46.

Burton TA. Urinary retention following cannabis ingestion. JAMA. 1979;242(4):351. https://doi.org/10.1001/jama.1979.03300040037022.CrossRefPubMed

47.

Honda M, Yoshimura N, Kawamoto B, Hikita K, Muraoka K, Shimizu S, et al. Anandamide transporter-mediated regulation of the micturition reflex in urethane-anesthetized rats. Int Urol Nephrol. 2016;48(9):1407–12. https://doi.org/10.1007/s11255-016-1329-5.CrossRefPubMed

48.

Walczak JS, Price TJ, Cervero F. Cannabinoid CB1 receptors are expressed in the mouse urinary bladder and their activation modulates afferent bladder activity. Neuroscience. 2009;159(3):1154–63. https://doi.org/10.1016/j.neuroscience.2009.01.050.CrossRefPubMed

49.

Gratzke C, Streng T, Stief CG, Downs TR, Alroy I, Rosenbaum JS, et al. Effects of cannabinor, a novel selective cannabinoid 2 receptor agonist, on bladder function in normal rats. Eur Urol. 2010;57(6):1093–100. https://doi.org/10.1016/j.eururo.2010.02.027.CrossRefPubMed

50.

Mukerji G, Yiangou Y, Agarwal SK, Anand P. Increased cannabinoid receptor 1-immunoreactive nerve fibers in overactive and painful bladder disorders and their correlation with symptoms. Urology. 2010;75(6):1514.e15–20. https://doi.org/10.1016/j.urology.2009.12.051.CrossRef

51.

Bakali E, Mbaki Y, Lambert DG, Elliott RA, Mason R, Tincello DG. Effects of cannabinoid receptor activation by CP55,940 on normal bladder function and irritation-induced bladder overactivity in non-awake anaesthetised rats. Int Urogynecol J. 2016;27(9):1393–400. https://doi.org/10.1007/s00192-015-2802-x.CrossRefPubMed

52.

•• Bakali E, Tincello D. Current understanding of cannabinoids and detrusor overactivity. Curr Bladder Dysfunct Rep. 2017;12(1):86–94. https://doi.org/10.1007/s11884-017-0414-7This review is an excellent companion paper to the present review and provides a comprehensive overview of the role of cannabinoids in detrusor overactivity.CrossRef

53.

Capasso R, Aviello G, Borrelli F, Romano B, Ferro M, Castaldo L, et al. Inhibitory effect of standardized cannabis sativa extract and its ingredient cannabidiol on rat and human bladder contractility. Urology. 2011;77(4):1006.e9–1006.e15. https://doi.org/10.1016/j.urology.2010.12.006.CrossRef

54.

Hiragata S, Ogawa T, Hayashi Y, Tyagi P, Seki S, Nishizawa O, et al. Effects of IP-751, ajulemic acid, on bladder overactivity induced by bladder irritation in rats. Urology. 2007;70(1):202–8. https://doi.org/10.1016/j.urology.2007.02.069.CrossRefPubMed

55.

Wróbel A, Szopa A, Serefko A, Poleszak E. A novel alternative in the treatment of detrusor overactivity? In vivo activity of O-1602, the newly synthesized agonist of GPR55 and GPR18 cannabinoid receptors. Molecules. 2020;25(6):1384. https://doi.org/10.3390/molecules25061384.CrossRefPubMedCentral

56.

• Wróbel A, Serefko A, Szopa A, Poleszak E. Stimulation of atypical cannabinoid receptor GPR55 abolishes the symptoms of detrusor overactivity in spontaneously hypertensive rats. Eur J Pharm Sci. 2020;150:105329. https://doi.org/10.1016/j.ejps.2020.105329This paper provides evidence for the role of the novel cannabinoid receptor GPR55.CrossRefPubMed

57.

Füllhase C, Schreiber A, Giese A, Schmidt M, Montorsi F, Gratzke C, et al. Spinal neuronal cannabinoid receptors mediate urodynamic effects of systemic fatty acid amide hydrolase (FAAH) inhibition in rats: spinal cannabinoid receptors and FAAH in rat bladder dysfunction. Neurourol Urodyn. 2016;35(4):464–70. https://doi.org/10.1002/nau.22753.CrossRefPubMed

58.

Ahn K, Johnson DS, Mileni M, Beidler D, Long JZ, McKinney MK, et al. Discovery and characterization of a highly selective FAAH inhibitor that reduces inflammatory pain. Chem Biol. 2009;16(4):411–20. https://doi.org/10.1016/j.chembiol.2009.02.013.CrossRefPubMedPubMedCentral

59.

Agarwal N, Pacher P, Tegeder I, Amaya F, Constantin CE, Brenner GJ, et al. Cannabinoids mediate analgesia largely via peripheral type 1 cannabinoid receptors in nociceptors. Nat Neurosci. 2007;10(7):870–9. https://doi.org/10.1038/nn1916.CrossRefPubMedPubMedCentral

60.

Walczak J-S, Cervero F. Local Activation of Cannabinoid CB ₁ receptors in the urinary bladder reduces the inflammation-induced sensitization of bladder afferents. Mol Pain. 2011;7:1744-8069-7–31. https://doi.org/10.1186/1744-8069-7-31.CrossRef

61.

Amaya F, Shimosato G, Kawasaki Y, Hashimoto S, Tanaka Y, Ji R-R, et al. Induction of CB1 cannabinoid receptor by inflammation in primary afferent neurons facilitates antihyperalgesic effect of peripheral CB1 agonist. Pain. 2006;124(1):175–83. https://doi.org/10.1016/j.pain.2006.04.001.CrossRefPubMed

62.

Merriam FV, Wang Z-Y, Hillard CJ, Stuhr KL, Bjorling DE. Inhibition of fatty acid amide hydrolase suppresses referred hyperalgesia induced by bladder inflammation. BJU Int. 2011;108(7):1145–9. https://doi.org/10.1111/j.1464-410X.2010.09583.x.CrossRefPubMed

63.

Wang Z-Y, Wang P, Bjorling DE. Activation of cannabinoid receptor 2 inhibits experimental cystitis. Am J Physiol Regul Integr Comp Physiol. 2013;304(10):R846–53. https://doi.org/10.1152/ajpregu.00585.2012.CrossRefPubMedPubMedCentral

64.

Wang Z-Y, Wang P, Bjorling DE. Treatment with a cannabinoid receptor 2 agonist decreases severity of established cystitis. J Urol. 2014;191(4):1153–8. https://doi.org/10.1016/j.juro.2013.10.102.CrossRefPubMed

65.

Tambaro S, Casu MA, Mastinu A, Lazzari P. Evaluation of selective cannabinoid CB1 and CB2 receptor agonists in a mouse model of lipopolysaccharide-induced interstitial cystitis. Eur J Pharmacol. 2014;729:67–74. https://doi.org/10.1016/j.ejphar.2014.02.013.CrossRefPubMed

66.

Liu Q, Wu Z, Liu Y, Chen L, Zhao H, Guo H, et al. Cannabinoid receptor 2 activation decreases severity of cyclophosphamide-induced cystitis via regulating autophagy. Neurourol Urodyn. 2020;39(1):158–69. https://doi.org/10.1002/nau.24205.

67.

Berger G, Arora N, Burkovskiy I, Xia Y, Chinnadurai A, Westhofen R, et al. Experimental cannabinoid 2 receptor activation by phyto-derived and synthetic cannabinoid ligands in LPS-induced interstitial cystitis in mice. Molecules. 2019;24(23):4239. https://doi.org/10.3390/molecules24234239.CrossRefPubMedCentral

68.

Farquhar-Smith WP, Rice AS. Administration of endocannabinoids prevents a referred hyperalgesia associated with inflammation of the urinary bladder. Anesthesiology. 2001;94(3):507–13; discussion 6A. https://doi.org/10.1097/00000542-200103000-00023.CrossRefPubMed

69.

• Cervigni M, Nasta L, Schievano C, Lampropoulou N, Ostardo E. Micronized palmitoylethanolamide-polydatin reduces the painful symptomatology in patients with interstitial cystitis/bladder pain syndrome. Biomed Res Int. 2019;2019:1–6. https://doi.org/10.1155/2019/9828397This paper describes one of the few studies investigating the role of PEA for treatment of interstitial cystitis/bladder pain syndrome in humans.CrossRef

70.

Wang Z-Y, Wang P, Hillard CJ, Bjorling DE. Attenuation of cystitis and pain sensation in mice lacking fatty acid amide hydrolase. J Mol Neurosci. 2015;55(4):968–76. https://doi.org/10.1007/s12031-014-0453-x.CrossRefPubMed

71.

Aizawa N, Gandaglia G, Hedlund P, Fujimura T, Fukuhara H, Montorsi F, et al. URB937, a peripherally restricted inhibitor for fatty acid amide hydrolase, reduces prostaglandin E ₂ -induced bladder overactivity and hyperactivity of bladder mechano-afferent nerve fibres in rats. BJU Int. 2016;117(5):821–8. https://doi.org/10.1111/bju.13223.CrossRefPubMed

72.

Gandaglia G, Strittmatter F, La Croce G, Benigni F, Bettiga A, Castiglione F, et al. The fatty acid amide hydrolase inhibitor oleoyl ethyl amide counteracts bladder overactivity in female rats: chronic FAAH inhibition counteracts detrusor overactivity. Neurourol Urodyn. 2014;33(8):1251–8. https://doi.org/10.1002/nau.22482.CrossRefPubMed

73.

Li GL, Winter H, Arends R, Jay GW, Le V, Young T, et al. Assessment of the pharmacology and tolerability of PF-04457845, an irreversible inhibitor of fatty acid amide hydrolase-1, in healthy subjects. Br J Clin Pharmacol. 2012;73(5):706–16. https://doi.org/10.1111/j.1365-2125.2011.04137.x.CrossRefPubMed

74.

Mallet C, Dubray C, Dualé C. FAAH inhibitors in the limelight, but regrettably. Int J Clin Pharmacol Ther. 2016;54(07):498–501. https://doi.org/10.5414/CP202687.CrossRefPubMedPubMedCentral

75.

Huggins JP, Smart TS, Langman S, Taylor L, Young T. An efficient randomised, placebo-controlled clinical trial with the irreversible fatty acid amide hydrolase-1 inhibitor PF-04457845, which modulates endocannabinoids but fails to induce effective analgesia in patients with pain due to osteoarthritis of the knee. Pain. 2012;153(9):1837–46. https://doi.org/10.1016/j.pain.2012.04.020.CrossRefPubMed

76.

Chinnadurai A, Berger G, Burkovskiy I, Zhou J, Cox A, Lynch M, et al. Monoacylglycerol lipase inhibition as potential treatment for interstitial cystitis. Med Hypotheses. 2019;131:109321. https://doi.org/10.1016/j.mehy.2019.109321.CrossRefPubMed

77.

Ignatowska-Jankowska B, Wilkerson JL, Mustafa M, Abdullah R, Niphakis M, Wiley JL, et al. Selective monoacylglycerol lipase inhibitors: antinociceptive versus cannabimimetic effects in mice. J Pharmacol Exp Ther. 2015;353(2):424–32. https://doi.org/10.1124/jpet.114.222315.CrossRefPubMedPubMedCentral

78.

Mohiuddin M, Blyth FM, Degenhardt L, Di Forti M, Eccleston C, Haroutounian S, et al. General risks of harm with cannabinoids, cannabis, and cannabis-based medicine possibly relevant to patients receiving these for pain management: an overview of systematic reviews. Pain. 2020;Publish Ahead of Print. https://doi.org/10.1097/j.pain.0000000000002000.

79.

Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018;3:CD012182. https://doi.org/10.1002/14651858.CD012182.pub2.CrossRefPubMed

80.

•• Carrubba AR, Ebbert JO, Spaulding AC, DeStephano D, DeStephano CC. Use of cannabis for self-management of chronic pelvic pain. J Women's Health. 2020. https://doi.org/10.1089/jwh.2020.8737This paper describes current trends in self-medication with cannabis in a population of women with chronic pelvic pain.

81.

Sinclair J, Smith CA, Abbott J, Chalmers KJ, Pate DW, Armour M. Cannabis use, a self-management strategy among Australian women with endometriosis: results from a national online survey. J Obstet Gynaecol Can. 2020;42(3):256–61. https://doi.org/10.1016/j.jogc.2019.08.033.CrossRefPubMed

82.

Tripp DA, Nickel JC, Katz L, Krsmanovic A, Ware MA, Santor D. A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome. Can Urol Assoc J. 2014;8(11–12):E901–5. https://doi.org/10.5489/cuaj.2268.CrossRefPubMedPubMedCentral

83.

Stochino-Loi E, Pontis A, Cofelice V, Pirarba S, Fais MF, Daniilidis A, et al. Effect of ultramicronized-palmitoylethanolamide and co-micronized palmitoylethanolamide/polydatin on chronic pelvic pain and quality of life in endometriosis patients: An open-label pilot study. Int J Women's Health. 2019;11:443–9. https://doi.org/10.2147/IJWH.S204275.CrossRef

84.

Cobellis L, Castaldi MA, Giordano V, Trabucco E, De Franciscis P, Torella M, et al. Effectiveness of the association micronized N-palmitoylethanolamine (PEA)-transpolydatin in the treatment of chronic pelvic pain related to endometriosis after laparoscopic assessment: a pilot study. Eur J Obstet Gynecol Reprod Biol. 2011;158(1):82–6. https://doi.org/10.1016/j.ejogrb.2011.04.011.CrossRefPubMed

85.

Indraccolo U, Indraccolo SR, Mignini F. Micronized palmitoylethanolamide/ trans-polydatin treatment of endometriosis-related pain: a meta-analysis. Ann Ist Super Sanita. 2017;53(2):125–34. https://doi.org/10.4415/ANN_17_02_08.CrossRefPubMed

86.

Nickel JC. Medical marijuana for urologic chronic pelvic pain. Can Urol Assoc J. 2018;12(6 Suppl 3):S181–3. https://doi.org/10.5489/cuaj.5331.CrossRefPubMedPubMedCentral

87.

Guo S-W, Wang Y. The prevalence of endometriosis in women with chronic pelvic pain. Gynecol Obstet Investig. 2006;62(3):121–30. https://doi.org/10.1159/000093019.CrossRef

88.

Sanchez AM, Cioffi R, Viganò P, Candiani M, Verde R, Piscitelli F, et al. Elevated systemic levels of endocannabinoids and related mediators across the menstrual cycle in women with endometriosis. Reprod Sci. 2016;23(8):1071–9. https://doi.org/10.1177/1933719116630414.CrossRefPubMed

89.

Dmitrieva N, Nagabukuro H, Resuehr D, Zhang G, McAllister SL, McGinty KA, et al. Endocannabinoid involvement in endometriosis. Pain. 2010;151(3):703–10. https://doi.org/10.1016/j.pain.2010.08.037.CrossRefPubMedPubMedCentral

90.

Escudero-Lara A, Argerich J, Cabañero D, Maldonado R. Disease-modifying effects of natural Δ9-tetrahydrocannabinol in endometriosis-associated pain. Elife. 2020;9:e50356. https://doi.org/10.7554/eLife.50356.CrossRefPubMedPubMedCentral

91.

Cinca DG. Effect of cannabinoid (THC / CBD 50%) on hyperalgesia in patients with deep endometriosis Report No.: NCT03875261. 2019. Clinicaltrials.gov. https://clinicaltrials.gov/ct2/show/NCT03875261. Accessed 11 February 2021.

92.

Wagenlehner FME, van Till JWO, Houbiers JGA, Martina RV, Cerneus DP, Melis JHJM, et al. Fatty acid amide hydrolase inhibitor treatment in men with chronic prostatitis/chronic pelvic pain syndrome: an adaptive double-blind, randomized controlled trial. Urology. 2017;103:191–7. https://doi.org/10.1016/j.urology.2017.02.029.CrossRefPubMed

Title: Cannabinoid Therapy in Female Pelvic Medicine and Reconstructive Surgery: Current Evidence and Future Directions
Authors: Jocelyn Stairs
Finlay Maguire
Christian Lehmann
Ashley Cox
Publication date: 01-09-2021
Publisher: Springer US
Keywords: Cystitis
Cannabinoid
Overactive Bladder
Endometriosis
Cystitis
Published in: Current Bladder Dysfunction Reports / Issue 3/2021
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI: https://doi.org/10.1007/s11884-021-00632-5

At a glance: The STEP trials

Springer Medicine

Cannabinoid Therapy in Female Pelvic Medicine and Reconstructive Surgery: Current Evidence and Future Directions

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 3/2021

Questionnaires to Evaluate Lower Urinary Tract Symptoms in Men and Women

Understanding the FDA Device Approval Process in FPMRS

Contemporary Review of MRI in Benign Genitourinary Pelvic Medicine: What Every Urologist Should Know

Optimizing Lead Placement in Sacral Neuromodulation

Neuroanatomy of Bladder Pain