The significance of endocannabinoid receptors and endocannabinoids in the lower urinary and genital tract

The cannabinoid receptor (CB) signal transduction is a complex system that is relatively widespread in mammalian cells and tissues. By regulating the local levels and actions of other chemical signals, it can activate multiple cascades in different organs. Cannabinoid receptors and endocannabinoids are also present in the human lower urinary tract (LUT) and genital tract, including the urinary bladder, prostate, urethra, penile erectile tissue and seminal vesicles. The present review aims to give an overview on what has emerged from basic research and clinical approaches on the role of the endocannabinoid system (ECS) in the human lower urinary tract and reproductive tissues. This review article highlights some key data from research into the cannabinoid system and its potential role in the control of micturition, reproductive functions and also dysfunctions of the lower urinary tract. While basic research findings on the ECS in reproductive tissues (penile erectile tissue, seminal vesicles) have not yet been supplemented by data from trials addressing clinical conditions such as erectile dysfunction (ED) and ejaculatory disorders (for example, premature ejaculation), targeting the ECS has been suggested as a pharmacological approach to treat disorders of bladder filling and storage functions. Despite some preclinical data may favor a role of receptors, ligands and regulatory proteins of the ECS in the LUT, additional clinical evidence is required in order to support a significance of a modulation of the pathways stimulated by cannabinoid molecules in the treatment of dysfunctions of the lower urinary and genital tract.