Among nearly 5 million matched pediatric patients, those with cannabis use disorder had significantly higher rates of pelvic pain, overactive bladder, dysuria, and urinary tract infections over five years.
Pediatric urologists, adolescent medicine providers, cannabis researchers
What the researchers found
After propensity score matching over 4.8 million male and 4.2 million female patients under 18, those with CUD showed significantly higher rates of new urinary symptom diagnoses at 5-year follow-up. Female CUD patients had elevated rates of pelvic pain (OR 2.3), overactive bladder (OR 1.6), dysuria (OR 1.2), and UTI (OR 1.8). Male CUD patients showed increased pelvic pain (OR 3.8), dysuria (OR 1.4), and UTI (OR 1.7).
Why it matters
Urinary symptoms in adolescents are rarely discussed in the context of cannabis use. This large database study suggests an underrecognized association that could inform clinical screening and patient counseling.
The numbers in context
~9.1 million patients screened; 11,840 matched males and 11,810 matched females per arm; median age ~15.5 years; female CUD: pelvic pain OR 2.3, OAB OR 1.6, UTI OR 1.8; male CUD: pelvic pain OR 3.8, UTI OR 1.7
How the study worked
Retrospective cohort study using the TriNetX Research Network. Male and female patients under 18 with or without CUD were propensity score matched for demographics and comorbidities. Primary outcomes: new diagnoses of LUTS, pelvic pain, overactive bladder, dysuria, or UTI at 5-year follow-up.
What this study cannot tell us
Administrative database cannot confirm actual cannabis use patterns. CUD diagnosis codes may capture severe cases only. Cannot determine causality. Propensity matching cannot account for unmeasured confounders. UTI association may reflect behavioral rather than physiological factors.
How to read the evidence
Moderate: very large matched cohort with 5-year follow-up, but administrative database with inherent limitations.
When this study was published
2025 publication
The bigger picture
Cannabinoid receptors are present throughout the urinary tract, providing a biological basis for these associations. As adolescent cannabis use increases, clinicians evaluating urinary symptoms in teens should consider cannabis use history.
Questions still open
- Through what mechanism might cannabinoids affect lower urinary tract function?
- Would cannabis cessation improve urinary symptoms in affected adolescents?
Read the original research
Cannabis Use is Associated With Lower Urinary Tract Symptoms in Pediatric Patients-A Large Claims Database Study.
Urology, 205, 187-195
Citation
Grutman, Aurora J; Gumma, Mohammad Elmojtaba; Page, Nicole; Gabrielson, Andrew T; Clifton, Marisa; DiCarlo, Heather. (2025). Cannabis Use is Associated With Lower Urinary Tract Symptoms in Pediatric Patients-A Large Claims Database Study.. Urology, 205, 187-195. https://doi.org/10.1016/j.urology.2025.07.014
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