Department of Urology, University of Washington Medical Center, Seattle, WA, USA.
Department of Urology, Tulane University, New Orleans, LA, USA.
Andrology. 2019 Mar;7(2):139-147. doi: 10.1111/andr.12585. Epub 2019 Feb 15.
In the United States of America (USA), cannabis is legal in 28 states for medical purposes and 8 states for recreational use. In 2016, the legal marijuana industry reached nearly $7 billion in sales in the USA alone. Although consumption continues to increase, the medical effects of marijuana remain understudied. Young males comprise the demographic most likely to consume cannabis, and these individuals will be most vulnerable to its short- and long-term consequences.
The purpose of this manuscript is to systematically review the available literature describing the effects of marijuana on male infertility, sexual health, and urologic neoplasms.
A comprehensive literature search was conducted using the Medline and Embase databases through May 2017. In vitro models, animal models, case series, case-control, and cohort designs were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was utilized to report results.
After exclusions, 91 articles were synthesized for qualitative analysis. Of these manuscripts, 30 pertained to marijuana and male infertility, 36 discussed cannabis and male sexual health/hormones, and 25 explored the relationship between marijuana and urologic neoplasms.
With respect to male factor fertility using semen parameters as a surrogate, cannabinoids likely play an inhibitory role. Data on marijuana and male sexual function are mixed but suggest that marijuana may enhance the subjective experience of sexual intercourse while potentially contributing to ED in a dose-dependent manner. Cannabis has been associated with both increased and decreased risk of malignancy depending upon the target organ. Marijuana exposure seems to be an independent risk factor for testis cancer, data on bladder cancer are conflicting, and the evidence on prostate cancer supports anti-neoplastic effects of cannabinoids.
Studies of the effects of cannabis suggest impact on urologic health and disease. Prospective, long-term studies are necessary for further elucidation of these effects.
在美国，大麻在 28 个州被用于医疗目的，在 8 个州被用于娱乐目的。2016 年，仅在美国，合法大麻产业的销售额就接近 70 亿美元。尽管大麻的消费仍在持续增长，但大麻的医学效应仍研究不足。年轻男性是最有可能消费大麻的人群，他们将最容易受到大麻的短期和长期影响。
本文旨在系统地综述现有的文献，描述大麻对男性不育、性健康和泌尿系统肿瘤的影响。
通过 Medline 和 Embase 数据库进行全面的文献检索，检索时间截至 2017 年 5 月。纳入了体外模型、动物模型、病例系列、病例对照和队列设计的研究。采用系统评价和荟萃分析的首选报告项目（PRISMA）声明报告结果。
排除后，对 91 篇文章进行了定性分析。这些文献中，30 篇涉及大麻和男性不育，36 篇讨论了大麻和男性性健康/激素，25 篇探讨了大麻和泌尿系统肿瘤之间的关系。
就使用精液参数作为替代的男性因素生育能力而言，大麻素可能起抑制作用。关于大麻和男性性功能的数据相互矛盾，但表明大麻可能会增强性体验的主观感受，同时可能会以剂量依赖的方式导致 ED。大麻与恶性肿瘤的风险增加或降低有关，具体取决于目标器官。大麻暴露似乎是睾丸癌的一个独立危险因素，膀胱癌的数据相互矛盾，而关于前列腺癌的证据则支持大麻素的抗肿瘤作用。
对大麻影响的研究表明它对泌尿系统健康和疾病有影响。需要进行前瞻性、长期研究以进一步阐明这些影响。
