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The genitourinary impacts of electronic cigarette use: a systematic review of the literature

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Abstract

Purpose

Electronic cigarette (e-cig) use is prevalent. The health implications of e-cig use on the genitourinary (GU) system are uncertain. This systematic review aims to evaluate how e-cig use impacts the GU system.

Methods

A systematic search was conducted in PubMed, Embase and Ovid alongside citation searching. Review articles, non-English papers, animal model/cell line studies or articles only on combustible cigarettes were excluded. Quality assessment was undertaken using the Joanna Briggs Institute checklists. The primary endpoint was the impact of e-cig use on bladder cancer incidence. Secondary outcomes included urinary carcinogens, chronic kidney disease (CKD), reproductive disorders, and other GU diseases.

Results

The search yielded 244 articles, 28 were ultimately included. One study assessed risk of bladder cancer and found the use of e-cig was associated with an increased odds ratio of 1.577 for its diagnosis. Twenty-one articles measured potential urinary carcinogens—including crotonaldehyde and benzene—associated with bladder cancer. Two articles evaluated the association of e-cig use with CKD and reported mixed outcomes. Three articles reported on reproductive disorders, specifically, stuttering priapism and changes to sperm quantity and quality. One study reported on other GU diseases, specifically burns to the GU system. After quality assessment, all articles were deemed to be of acceptable quality for inclusion.

Conclusions

E-cig use was associated with an increased risk of bladder cancer, increased exposure to carcinogenic compounds, mixed evidence on CKD, increased risk of reproductive disorders and burns to the GU system. Further studies are needed to understand long-term GU effects.

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Authors and Affiliations

  1. Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Nilanga Aki Bandara

  2. Vagelos College of Physicians and Surgeons, Columbia University, New York, USA

    Xuan Randy Zhou

  3. Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Level 6, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada

    Abdullah Alhamam, Peter C. Black & Marie-Pier St-Laurent

  4. Department of Urology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

    Abdullah Alhamam

  5. Vancouver Prostate Centre, Vancouver, Canada

    Peter C. Black & Marie-Pier St-Laurent

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  1. Nilanga Aki Bandara
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Contributions

NAB: protocol/project development, data collection, data analysis, and manuscript writing/editing. XRZ: protocol/project development, data collection, data analysis, and manuscript writing/editing. AA: manuscript writing/editing, data analysis, and supervision. PCB: manuscript writing/editing, data analysis, and supervision. MPS: protocol/project development, data analysis, supervision, and manuscript writing/editing.

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Correspondence to Marie-Pier St-Laurent.

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Bandara, N.A., Zhou, X.R., Alhamam, A. et al. The genitourinary impacts of electronic cigarette use: a systematic review of the literature. World J Urol 41, 2637–2646 (2023). https://doi.org/10.1007/s00345-023-04546-1

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