Night-time micturition, called nocturia, is a very common problem that unfavourably
influences sleep- and life-qualities. The International Continence Society (ICS) defines
nocturia as micturition once or several times during the night. Nocturia is one of the
cardinal symptoms of overactive bladder (OAB). Persons with nocturia have the intention to
continue sleep after going to the toilet which does not succeed to the same extent, depending
on age.
The natural occurrence of the plant, Bryophyllum pinnatum (BP) which is used in this
observational study origins from Madagascar as well as in tropical Africa, South America and
Asia. In the folk medicine of these countries BP is widely used. BP has a calming,
spasmolytic, anti-inflammatory, pain-relieving, diuretic and cytotoxic effects.
According to previous preclinical and clinical studies the inhibiting effect of BP on
overactive bladder was proven. The pharmacological effect of this plant on uterine smooth
muscle cells, on spontaneous and oxytocin-stimulated contractions, and on detrusor muscle
cells in an in-vitro model of the pig's bladder was shown. Smooth muscle relaxation is not
only required for preventing premature labour but also for symptom's relief of overactive
bladder (OAB). The flavonoid, aglycons and bufadienolides, are components of the pressed
juice of the BP leaves that have comparable effects to the standard drug oxybutynin on
vesical smooth muscle cells.
Since many year BP is used in obstetrics not only as tocolytics but also as a sedative and
sleeping pill.
There are known only few adverse events, such as skin irritation by intravenous application.
The interest in phytotherapeutical drugs for treatment the chronic diseases is very high and
Bryophyllum is also frequently used in Switzerland for hyperactive conditions.
In Switzerland, following the vote on complementary medicine on 17.05.2009, alternative
treatments will be covered by basic health insurance. Definitive inclusion in the catalogue
of benefits will be granted if effectiveness, safety and cost-effectiveness can be
demonstrated.
The potential and side-effect profile of BP, as well as the social interest in research into
alternative methods is the background to the implementation of this observational study.