Role of vitamin D in common urological conditions: a narrative review of past decade literature

Abstract

Background and Objective: To perform a literature update of the past decade on potential role of vitamin D in common urological entities: prostatic malignancy and benign hyperplasia, stone disease, urinary tract infections and male infertility. Vitamin D (or calciferol) is the pivotal regulator of calcium in humans and low levels are associated with bone health in children and adults. Recent research though has spread in several other fields including common urological conditions. Early reports indicate that vitamin D deficiency might be associated with increased risk of prostate cancer and hyperplasia, stone disease, semen impairment and urinary tract infections. Methods: A non-systematic search in PubMed/Medline, Google Scholar, Web of Science, and Embase was performed using the terms “vitamin D” and “benign prostatic hyperplasia/enlargement”, “prostate cancer”, “prostate malignancy”, “urolithiasis”, “nephrolithiasis”, “male infertility”, “urinary tract infections”. The search duration period was set between 2011 and 2021. Exclusion criteria were non-English and retracted studies. Key Contents and Findings: In prostate cancer, vitamin D deficiency is associated with adverse outcomes, but its usage needs to be clarified. In hyperplasia, correlations are not certain. In contrast, in urolithiasis, the achievement of a normocalciemic status should be considered the primary goal in terms of prevention and reduction of recurrence. Moreover, vitamin D seems to regulate host immunity. In children, pregnant and women of reproductive age, screening for deficiency might be of benefit, whereas supplementation may be used as a secondary tool in the management of urinary tract infections. In infertile men, treating deficiency might be a cost-effective approach instead of a multi-panel empirical antioxidant treatment but its role needs further evaluation. Conclusions: Although highest level of evidence still lacking to support vitamin D administration as per guidelines practice, last decade research looks promising in terms of its role and its therapeutic potential. The specific indications, the exact dosages and safety profile need to be established with future research.