Table 2 Single-herb medications for overactive bladder treatment

Alpinia oxyphylla

Zingiberaceae

Sharp-leaf galangal, yì zhì 益智

Fruit (izalpinin)

Antagonized Carbachol-induced bladder strip contractions concentration-dependently

Rat bladder detrusor strips

Muscarinic receptor antagonistic action

[168]

Artemisia monosperma

Compositae

Wormwood

Aerial parts (7-O-methyleriodictyol)

Reduced bladder tone

Rat isolated bladder

NA

[3]

Artemisia vulgaris

Compositae

Common mugwort, wild wormwood, and felon herb

Aerial parts

Inhibited carbachol induced bladder contractions

Rabbit urinary bladder tissues/ strips

Mediation via dual, anticholinergic and Ca²⁺ antagonist mechanisms

[78]

Aspalathus linaeris

Fabaceae

Rooibos (meaning “red bush”)

Aerial parts

Inhibited carbachol induced bladder contractions

Rabbit urinary bladder tissues/ strips

Via dominant KATP channel opening and weak Ca²⁺ channel blockade pathways

[78]

Astragalus membranaceus

Leguminosae

Milkvetch or Huangqi, huáng qí 黄芪

Root (Astragalus polysaccharides, APS and Astragaloside I, AS-IV)

Ameliorated urinary frequency

CYP-induced OAB female mice model

Modulation of urothelial wound healing

[32]

Bletilla striata

Orchidaceae

Chinese ground orchid, bái jī 白芨

Pseudobulbs

Reduced AWR scores and amplitude of bladder detrusor‐EMG, extended micturition interval and increased storage of urine

Zymosan‐induced cystitis in female rats

NA

[97]

Bridelia ferruginea

Euphorbiaceae

Bridelia; Kirni, Kimi (Hausa), Maren (Fulani), Iralodan (Yoruba), and Oha, Ede, Ola in Igbo

Leaf (ethanol extracts)

Reduced KCl induced bladder contractile response

Rat bladder smooth

muscle

Blockade of purinergic neurotransmission

[116]

Bryophyllum pinnatum

Crassulaceae

Airplant, life plant, Mother of Thousands, Miracle Leaf

Leaf

1. Reduced the electrically and carbachol-induced porcine DSM contractile response

2. Improved OAB symptoms, reduced micturition frequency in postmenopausal women

3. The flavonoid fraction decreased the porcine detrusor contractility dose- and time-dependently

1. Porcine detrusor strips

2. 20 postmenopausal female with OAB or urgency-dominant mixed urinary incontinence (MUI)

3. Porcine detrusor strips

1. NA

2. NA

3. NA

1. [129]

2. [18]

3. [48]

Camellia sinensis

Theaceae

Green tea

Leaf (EGCG)

1. Restored ovariectomy (OVX)-induced bladder dysfunction dose-dependently

2. Mitigated storage dysfunction, and protected the bladders from Metabolic syndrome (MetS) and OVX-induced interstitial fibrosis changes, alleviated bladder apoptosis

1. Surgical menopause-induced OAB rat model

2. Rat model with MetS and ovarian hormone deficiency

1. Antioxidant, anti-fibrosis and anti-apoptosis effects

2. Mitochondria and ER apoptosis pathways

1. [72]

2. [89]

Cananga odorata

Annonaceae

Ylang-ylang

Flower

Inhibited EFS and agonists induced urinary bladder contractile effects

In vitro: male Sprague–Dawley rats detrusor muscle strips

In vivo: rabbit

c-AMP pathway

[79]

Cannabis sativa

Cannabaceae

Hemp

Whole plant (tetrahydrocannabinol, THC and cannabidiol, CBD)

1. Decreased urinary urgency, the number and volume of incontinence episodes, frequency and nocturia, improved patient self-assessment of pain, spasticity and quality of sleep

2. Reduced urge incontinence episodes

3. Reduced nicturia episodes, voids/ day, and the daytime voids, improved PGIC

4. Cannabidiol inhibited cholinergic-induced bladder smooth muscle contractions

1. 15 patients with advanced MS and refractory LUTS

2. 630 MS patients

3. 135 patients with MS and OAB

4. Strips cut from male Wistar rats and the human bladder body

1. NA

2. NA

3. NA

4. Modulation of TRPV1 in rats but not in humans

1. [24]

2. [46]

3. [76]

4. [26]

Capsicum annuum

Solanaceae

Chili pepper

Fruit

Improved clinical or urodynamic symptoms in 84.3% of the patients

A meta-analysis of 8 open and 2 placebo-controlled human clinical trials involving 200 patients with LUTS

NA

[36]

Citrus depressa

Rutaceae

Shekwasha

Fruit (Nobiletine)

Decreased micturition frequency

CYP-induced cystitis rats

The increase in intracellular cAMP in the bladder smooth muscles

[67]

Cucurbita pepo

Cucurbitaceae

Pumpkin

Seed (oil)

1. Reduced bladder pressure, increased bladder compliance, reduced urethral pressure

2. Reduced the degree of OABSS

3. Relieved BPH symptoms with no side effects

1. Rabbit

2. 45 volunteers (male: female = 25:20; age 41‐80 years)

3. 73 patients with BPH aged ≥ 50 years (single-blind randomized)

1. NA

2. NA

3. NA

1. [173]

2. [113]

3. [169]

Cyclotrichium niveum

Lamiaceae

Külotu (dag nanesi)

Aerial parts (essential oil)

Relaxed carbachol precontracted bladder strips

Rabbit bladder strip

NA

[29]

Euphorbia resinifera

Euphorbiaceae

African Spurge, Euphorbium, Resin Spurge

Resin (Resiniferatoxin, RTX)

1. Reduced bladder pain, and increased MCC; no significant improvement in frequency, nocturia, incontinence or FDC

2. Increased pain sensation, decreased bladder capacity, increased urinary frequency, and increased nociceptive behaviors

1. A meta-analysis of 7 trials of 355 patients with either IC or DO

2. Female Sprague–Dawley rats

1. NA

2. NA

1. [52]

2. [126]

Galium aparine

Rubiaceae

cleavers

Aerial parts

Traditionally used in cystitis

NA

NA

[25]

Ganoderma lucidum

Ganodermataceae

Reishi (in Japan) or líng zhī 灵芝 (in China) mushroom

1. Fruit body

2. Spore

1. Improved IPSS in men with LUTS

2. Counteracted the negative effects of ischemia/reperfusion (I/R) on bladder compliance and contractile responses

1. 50 male volunteers, ≥ 50 years old (double-blind, placebo-controlled randomized and dose-ranging)

2. In vivo I/R rabbit model

1. NA

2. Antioxidant effects

1. [114]

2. [90]

Glycine max

Fabaceae

Soybean

Seed (Daidzein and Genistein, phytoestrogens)

1. Genistein relaxed detrusor contracted with the muscarinic receptor agonist

2. A reduced risk of LUTS was associated with dietary intake of soy isoflavones

3. Reduced detrusor contractions induced by EFS dose-dependently

1. Isolated strips of rabbit detrusor

2. A Cross-sectional study on 2000 elderly Chinese men

3. Whole rat urinary bladders: in vivo treatment, ex vivo contractility examination

1. Inhibition of voltage operated Ca²⁺ channels (VOCCs)

2. NA

3. Activation of large and small conductance K⁺(Ca) channels

1. [120]

2. [155]

3. [147]

Hippophae rhamnoides

Elaeagnaceae

Seaberry, sea buckthorn

Fruit

1. Ursolic acid and isorhamnetin 7-O-rhamunoside inhibited Carbachol and TGF-β-induced constriction

2. Improved emotional parameters associated with urinary dysfunction

1. Rat bladder muscle strips; human bladder smooth muscle cells

2. Japanese male and female with mild urinary dysfunction

1. Ursolic acid and related compounds in seaberry extract may directly bind to the TGF-β receptor

2. NA

1. [132]

2. [140]

Hypericum perforatum

Hypericaceae

St John’s wort

Flowering top

Inhibited EFS-induced contractility

Rat urinary bladder strips

The inhibitory effect on excitatory transmission involve opioid receptors, at least partly

[27]

Perilla frutescens

Lamiaceae

Beefsteak plant

Leaf

Increased in the micturition interval, improved frequent urination

Female SHR rats

Improvement of the urothelial presence, anti-inflammatory effects

[84]

Peucedanum japonicum

Apiaceae

Coastal hog fennel

Whole plant extract / Isosamidin

1. The extract inhibited agonist-induced rabbit bladder contractile response; decreased micturition frequency

2. Isosamidin inhibited phenylephrine‐stimulated contractions dose‐dependently

3. The extract improved IPSS-QOL score; improved nocturia, and OABSS-2

1. Rabbit bladder strips; acetic acid-induced hypertensive bladder in rats

2. Human bladder and prostate strips from 9 to 10 male patients

3. 20 patients (male, age ≥ 50 years, with untreated LUTS, and no serious complications

1. NA

2. NA

3. NA

1. (Ito Y, 2013)

2. [139]

3. [74]

Potentilla chinensis

Rosaceae

Chinese Cinquefoil

Aerial part (aqueous extract)

1. Attenuated RA-induced DO in rats

2. Attenuated DO in rats with hemorrhagic cystitis

1. RA-induced DO in rats

2. CYP-induced hemorrhagic cystitis in rats

1. Inhibition on the release of transmitters from afferent and efferent fibres; influence on the exocytotic process depending on SNARE protein activity

2. Inhibition on the release of transmitters from afferent and efferent fibres; antioxidant effects

1. [156]

2. [73]

Puerariae lobatae

Leguminosae

Kudzu, Gegen, gé gēn 葛根

Dried root (water extract)

1. Induced detrusor relaxation in urothelium- independent manner

2. Improved DSM overactivity

1. Isolated rat bladder strips

2. Male SHR rats

1. NA

2. Neurogenic and anti-muscarinic (M3 receptor) mechanisms

1. [92]

2. [175]

Rhois aromatica

Anacardiaceae

Sweet sumach bark

Whole plant

Inhibited Carbachol and KCl-induced contractions

Rat and human bladder

Direct antagonistic effect on muscarinic receptors

[21]

Salvia cinnabarina

Lamiaceae

Cinnabar Sage

Aerial parts (3,4-secoisopimar-4(18),7,15-triene-3-oic acid)

Inhibited EFS-contratile response in a dose-dependent manner

Male Wistar rat bladders

NO production

[28]

Serenoa repens

Palmae

Saw palmetto

Fruit

1. Improved bladder voiding and LUTS, IPSS and NIH-CPSI, as well as erectile function

2. Decreased contractility and hyperplasia, improved smooth muscle fiber structure and reduced cell proliferation in the bladder

3. Improved IPSS-QOL score, nocturia, and OABSS-2

4. Alleviated daytime frequency and nocturia

5. NA

1. 591 patients with chronic benign prostate conditions related to inflammation

2. Obese male Wistar rats induced by high-carbohydrate diet

3. 20 male patients with untreated LUTS, and no severe complications, age ≥ 50 years

4. 76 adult women with urinary symptoms

5. NA

1. NA

2. NA

3. NA

4. NA

5. Antiandrogenic action, anti-inflammatory/anti-oedematous effect, prolactin signal modulation in benign prostatic hyperplasia

1. [51]

2. [41]

3. [74]

4. [162]

5. [50]

Silybum marianum

Asteraceae

Silymarin

Seed

Reduced contractile response in cystitis

CYP-induced cystitis rat model

Antioxidant and anti-inflammatory effects

[40]

Solanum lycopersicum

Solanaceae

Saladette tomato

Fruit (lipidic extract)

Decreased contractility and hyperplasia, improved smooth muscle fiber structure and reduced cell proliferation in the bladder

High-carbohydrate diet induced obese Wistar rats (male)

NA

[41]

Solidaginis virgaurea

Asteraceae

European golden rod

Whole plant

Inhibit Carbachol and KCl-induced contractions

Rat and human bladder strips

Direct antagonistic effect on muscarinic receptors

[21]

Uncariae Ramulus Cum Uncis

Rubiaceae

Gambir Plant, gōu ténɡ  钩藤

Branch with hooks (Rhynchophylline)

1. Inhibited the contraction of urinary bladder strips

2. Reduced the maximum bladder capacity, bladder filling pressure, leak point pressure, contraction frequency, and motility index

1. Isolated rat urinary bladder strips

2. Rats with infravesical outflow obstruction

1. Blockade of L-type calcium channel and activation of calcium-activated potassium channel

2. Blockade of L-type calcium channels and activation of big- conductance calcium-activated potassium channels

1. [70]

2. [71]

Vaccinium corymbosum

Ericaceae

Blueberry

Fruit

Prevented the progression of bladder dysfunction resulting from BOO

BOO rats

Antioxidation and the inhibition of bladder remodeling

[108]

Vanilla planifolia

Orchidaceae

Vanilla

Fruit (oil)

Vanilla oil reduced serum catecholamine levels and urination frequency in rats under light urethane anesthesia

Sprague–Dawley rats

Reduction of sympathetic activity

[138]

Vitis vinifera

Vitaceae

Grape

Fruit (grape suspension, Resveratrol)

1. Protective effects on the decreased contractile response of isolated bladder strips to a field stimulation (FS) induced by H₂O₂

2. Reversed increases in non-voiding contractions, post-voiding pressure and voiding frequency; lowered ROS levels and serum lipid per-oxidation in bladder tissues

3. Resveratrol improves OAB

1. Male rabbit bladders

2. Obese mice

3. Rats with chronic prostatitis

1. Protection of the citrate synthase to the oxidative effects of H₂O₂ activity of the muscle

2. Anti-oxidant effects

3. Downregulation of the protein expression of SCF, c-Kit and p-AKT

1. [44]

2. [6]

3. [167]

Zea mays

Poaceae

Purple corn

Flowering top (stigma), corn silk

Traditionally used in cystitis

NA

NA

[30]