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Grapes and Urinary Bladder Function

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Abstract

The function of the urinary bladder is to collect and store urine at low intravesical pressure and then, periodically, to expel the urine via a highly coordinated and sustained contraction. Bladder function depends on several factors including state of innervation, vascularization, structure of the organ as a whole, contractile response of the smooth muscle (SM) elements to autonomic stimulation, availability of metabolic energy (cytosolic adenosine triphosphate [ATP] and mitochondrial oxidative metabolites), and the density and distribution of the connective tissue in the detrusor. These factors are intimately connected, and an alteration in one factor can induce substantial adaptive changes in the others.

Urinary bladder outlet obstruction is a common medical problem. More than 80 % of males older than 50 years of age have varying degrees of bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH). Our current studies are focused on: (1) correlating obstructive bladder dysfunction with ischemia, ischemia followed by reperfusion (I/R), and oxidative stress (generation of free radicals and protein, lipid and phospholipid oxidation and peroxidation), and (2) demonstrating that natural products that have a high antioxidant and membrane-protective activities, such as grapes, are effective in reducing the progression and severity of partial bladder outlet obstruction, ischemia, ischemia followed by reperfusion, and oxidative stress.

In a series of studies, we demonstrated that oral administration of a standardized grape suspension (equal to 3–8 oz glasses of mixed grape juice per day) can significantly protect the urinary bladder from obstructive and ischemic damage. As mentioned above, partial outlet obstruction secondary to BPH is the most common dysfunction men over 50 develop. It can result in bladder smooth muscle hypertrophy, mucosal hyperplasia, nocturia, incomplete emptying, reduced intravesical pressure, and significantly decreased compliance. The progression from a compliant bladder to severe obstructive bladder dysfunction is significantly reduced in both severity and progressive dysfunction by oral administration of the grape suspension. Using an in vivo model of ischemia and ischemia followed by reperfusion, we clearly demonstrated that oral ingestion of the grape suspension protected the bladder from the physiological, biochemical, and morphological dysfunctions mediated by ischemia and ischemia followed by reperfusion.

Ischemia, ischemia followed by reperfusion, and oxygen stress are also directly involved in the etiology of several bladder dysfunctions in women including interstitial cystitis and incontinence. Although we did not test the effects of oral ingestion of the grape suspension on female rabbit models of these bladder dysfunctions, based on the studies published, we would expect that the grape suspension would be effective in reducing the level and progression of these two models of female bladder dysfunction.

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Acknowledgments

Funding for these studies has been made available by the Governor’s Buy California Initiative, the California Department of Food and Agriculture (CDFA), the US Department of Agriculture (USDA), and by the California Table Grape Commission. In addition, this material is based upon work supported, in part, by the Office of Research and Development Medical Research Service, Department of Veteran’s Affairs, partially by NIH grant R01-DK067114 and in part by the Capital Region Medical Research Foundation.

We would like to thank the California Table Grape Commission for supplying the Standardized Grape Preparation.

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  1. Stratton VA Medical Center, 113 Holland Ave, Albany, NY, 12208, USA

    Robert M. Levin Ph.D., Robert E. Leggett & Catherine Schuler

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  1. Robert M. Levin Ph.D.
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  2. Robert E. Leggett
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  3. Catherine Schuler
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Correspondence to Robert M. Levin Ph.D. .

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  1. A & M Schwartz Coll of Pharm & Health Sc, Long Island University, Hilo, Hawaii, USA

    John M. Pezzuto

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Levin, R.M., Leggett, R.E., Schuler, C. (2016). Grapes and Urinary Bladder Function. In: Pezzuto, J. (eds) Grapes and Health. Springer, Cham. https://doi.org/10.1007/978-3-319-28995-3_10

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