Bladder overactivity and vitamin D

Few studies about vitamin D and its relation to bladder overactivity and incontinence have been done despite the association between vitamin D and muscle weakness and coordination. The only two I have found show a correlation with decreasing vitamin D levels and female pelvic floor disorders incl. urinary incontinence(1) and risk of onset of overactive bladder.(2) Especially with age. The studies have been made on women only, but there is no reason to believe men should differ in this respect.

Another study has also shown that bladder cells (“bladder epithelium and stromal cells along with vascular endothelial cells”) contain vitamin D receptoirs (as most of the other cells of the body also do) and that treatment with vitamin D analogues “inhibits basal and androgen-stimulated human bladder cell growth and enhances their apoptosis” and “prevent[s] starvation-induced cell phenotype modification”.(3) All factors thought to cause overactive bladder.

Thus different lines of evidence point at low vitamin D levels being a possible causative agent. As CPPS show distinct seasonality with summertime improvement, the studies are interesting and one can hope vitamin D levels will be studied in CPPS sufferers.

On a personal note I have been treating myself with vitamin D since 2008 (after noting the distinct seasonality of my symptoms) and have noted a distinct remission of all CPPS problems

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, värme, sommar, D-vitamin, inkontinens.
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(1) Badalian SS, Rosenbaum PF. Vitamin D and pelvic floor disorders in women. Obstet gynecol 115(4):795-803, 2010.
(2) Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM. Leicestershire MRC incontinence study group. Nutrient composition of the diet and the development of overactive bladder: a longitudinal study in women. Neururol urodyn 23:204-210, 2004.
(3) Crescioli C et al. Human Bladder as a Novel Target for Vitamin D Receptor Ligands. J Clin Endocrin Metabol 90(2):962-972, 2005.

Bladder lining findings

Many CPPS sufferers react with pain/discomfort on potassium instillations (a potassium ion containing fluid is injected into the bladder) in a manner similar to IC patients, but the so called potassium sensitivity test is not wholly reliable as both false negatives and positives are common. It is believed that the potassium sensitivity is caused by impaired “barrier function” of the bladder urothelium to irritants or cytotoxic substances in the urinary fluid. It is assumed that potassium influx into nerve and muscular cells causes abnormal nerve firing and muscular relaxation.

Sulfated polysaccharides, like heparin, are thought to lower adherence to the bladder and urethral etc mucosal wall, which would also improve urine flow dynamics. If adherence increases bacteria, molecules etc can attach to the surface, as well as flow become more turbulent.

Other research has shown that instillation with resinifera-toxin modulates nerve firing in such a way as to (permanently?) alleviate bladder related symptoms. See additional discussion under treatment.

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, urinblåsa