Cannabinoids and the endocannabinoid system in lower urinary tract function and dysfunction

Neurourol Urodyn. 2014 Jan;33(1):46-53. doi: 10.1002/nau.22442.


Aims: To review knowledge on cannabinoids and the endocannabinoid system in lower urinary tract function and dysfunction.

Methods: Review of MEDLINE using defined search terms, and manual analysis. Articles published in English were included.

Results and discussion: Components of the endocannabinoid system—cannabinoid (CB)receptor types 1 and 2, anandamide, and fatty acid amide hydrolase (FAAH), which degrades anandamide and related fatty-acid amides—have been located to lower urinary tract tissues of mice, rats, monkeys, and humans. Studies have located CB receptors in urothelium and sensory nerves and FAAH in the urothelium. CB receptor- and FAAH-related activities have also been reported in the lumbosacral spinal cord. Data on supraspinal CB functions in relation to micturition are lacking. Cannabinoids are reported to reduce sensory activity of isolated tissues, cause antihyperalgesia in animal studies of bladder inflammation, affect urodynamics parameters reflecting sensory functions in animals models, and appear to have effects on storage symptoms in humans. FAAH inhibitors have affected sensory bladder functions and reduced bladder overactivity in rat models. Cannabinoids may modify nerve-mediated functions of isolated lower urinary tract tissues.

Conclusions: Evidence suggests components of the endocannabinoid system are involved in regulation of bladder function, possibly at several levels of the micturition pathway. It is unclear if either CB receptor has a dominant role in modification of sensory signals or if differences exist at peripheral and central nervous sites. Amplification of endocannabinoid activity by FAAH inhibitors may be an attractive drug target in specific pathways involved in LUTS.

Publication types

  • Review

MeSH terms

  • Amidohydrolases / antagonists & inhibitors
  • Amidohydrolases / metabolism
  • Animals
  • Cannabinoids / therapeutic use*
  • Disease Models, Animal
  • Endocannabinoids / metabolism*
  • Enzyme Inhibitors / therapeutic use
  • Humans
  • Lower Urinary Tract Symptoms / drug therapy*
  • Lower Urinary Tract Symptoms / metabolism
  • Lower Urinary Tract Symptoms / physiopathology
  • Receptors, Cannabinoid / drug effects
  • Receptors, Cannabinoid / metabolism
  • Signal Transduction / drug effects
  • Urinary Bladder / drug effects*
  • Urinary Bladder / metabolism
  • Urinary Bladder Diseases / drug therapy*
  • Urinary Bladder Diseases / metabolism
  • Urinary Bladder Diseases / physiopathology
  • Urination / drug effects
  • Urodynamics / drug effects
  • Urological Agents / therapeutic use*


  • Cannabinoids
  • Endocannabinoids
  • Enzyme Inhibitors
  • Receptors, Cannabinoid
  • Urological Agents
  • Amidohydrolases
  • fatty-acid amide hydrolase