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Franco JVA, Trivisonno LF, Sgarbossa N, Alvez GA, Fieiras C, Escobar Liquitay CM, Jung JH. Serenoa repens for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Enlargement: An Updated Cochrane Review. World J Mens Health 2024; 42:42.e11. [PMID: 38164033 DOI: 10.5534/wjmh.230222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/27/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE To assess the effects of Serenoa repens in the treatment of men with lower urinary tract symptoms (LUTS) consistent with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS We performed a comprehensive search using multiple databases up to September 2022 with no language or publication status restrictions. We included parallel-group randomized controlled trials of participants with BPH who were treated with Serenoa repens or placebo/no treatment. We used standard Cochrane methods, including a GRADE assessment of the certainty of the evidence (CoE). RESULTS We included 27 studies involving a total of 4,656 participants. Serenoa repens results in little to no difference in urologic symptoms at short-term follow-up (International Prostate Symptom Score [IPSS]: mean difference [MD] -0.90, 95% confidence interval [CI] -1.74 to -0.07; I²=68%; 9 studies, 1,681 participants; high CoE). Serenoa repens results in little to no difference in the quality of life at short-term follow-up (high CoE). Serenoa repens probably results in little to no difference in adverse events (moderate CoE). Different phytotherapeutic agents that include Serenoa repens may result in little to no difference in urologic symptoms compared to placebo at short-term follow-up (IPSS: MD -2.41, 95% CI -4.54 to -0.29; I²=67%; 4 studies, 460 participants; low CoE). We are very uncertain about the effects of these agents on quality of life (very low CoE). These agents may result in little to no difference in the occurrence of adverse events (low CoE). CONCLUSIONS Serenoa repens alone provides little to no benefits for men with LUTS due to benign prostatic enlargement. There is more uncertainty about the role of Serenoa repens in combination with other phytotherapeutic agents.
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Affiliation(s)
- Juan Víctor Ariel Franco
- Institute of General Practice, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | | | | | - Gustavo Ariel Alvez
- Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Fieiras
- Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Jae Hung Jung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea
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Shin D, Yoon BI, Bang S, Bae WJ, Ha US, Kim S, Piao J, Kim JH, Koo GB, Jeon KH, Kim TH, Kim SW. Safety and Efficacy Assessment of Red Ginseng Oil (RXGIN) in Men with Lower Urinary Tract Symptoms in a Randomized, Double-Blind, Placebo-Controlled Trial. World J Mens Health 2024; 42:229-236. [PMID: 37652660 PMCID: PMC10782132 DOI: 10.5534/wjmh.230172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/08/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the efficacy and safety of red ginseng oil (RXGIN) in men with lower urinary tract symptoms. MATERIALS AND METHODS Men aged between 40 and 75 years with a total International Prostate Symptom Score (IPSS) of 8 to 19 points were recruited from April 2020 to December 2020. Subjects were randomly assigned to either the RXGIN group or the control group in a 1:1 ratio and received either RXGIN or placebo daily for 12 weeks. For the primary outcome, changes in IPSS scores at 6 and 12 weeks from baseline were analyzed. The secondary outcomes were changes in International Index of Erectile Function (IIEF), maximum urinary flow rate, and post-void residual volume at weeks 6 and 12 compared to baseline. Urine analysis and blood tests were additionally performed for safety assessment. RESULTS A total of 88 subjects (RXGIN group, 46; control group, 42) completed the study. The total IPSS and IPSS subscores (residual urine sensation, frequency, intermittency, urgency, weak stream, straining, nocturia, and quality of life) were significantly improved in the RXGIN group compared to the control group at weeks 6 and 12. Total IIEF and sexual desire were significantly improved in the RXGIN group at week 6 and week 12, respectively, but there were no significant changes in the level of serum testosterone or dihydrotestosterone. The serum prostate-specific antigen showed significant decrease at weeks 12. No serious adverse events leading to discontinuation of the study drug were observed in the RXGIN group. CONCLUSIONS Red ginseng oil (RXGIN) appears to be safe and effective in improving lower urinary tract symptoms in men and may also improve some aspects of sexual function.
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Affiliation(s)
- Dongho Shin
- Department of Urology, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Byung Il Yoon
- Department of Urology, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Seokhwan Bang
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woong Jin Bae
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - U-Syn Ha
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soomin Kim
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Junjie Piao
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Jong Han Kim
- Laboratory of Efficacy Research, Korea Ginseng Corporation, Daejeon, Korea
| | - Gi-Bang Koo
- Laboratory of Efficacy Research, Korea Ginseng Corporation, Daejeon, Korea
| | - Kyung-Hwa Jeon
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | | | - Sae Woong Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
- Green Medicine Co., Ltd., Busan, Korea.
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3
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Crescioli G, Maggini V, Raschi E, Gonella LA, Luxi N, Ippoliti I, Di Giovanni V, Bonaiuti R, Firenzuoli N, Gallo E, Menniti-Ippolito F, Moretti U, Trifirò G, Vannacci A, Firenzuoli F, Lombardi N. Suspected adverse reactions to medications and food supplements containing Serenoa repens: A worldwide analysis of pharmacovigilance and phytovigilance spontaneous reports. Phytother Res 2023; 37:5289-5299. [PMID: 37463655 DOI: 10.1002/ptr.7960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/05/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023]
Abstract
The safety of Serenoa repens (SR)-containing products was evaluated conducting a retrospective worldwide analysis of pharmaco- and phytovigilance report forms of suspected adverse reactions (SARs) collected up to 31 January 2022. Multivariate logistic regression was performed to estimate the odds ratios (ORs) of serious SAR. A total of 1810 report forms were analysed; 92% of subjects were males, with a median age of 69 years; 44% of cases were defined as serious. Subjects exposed to dietary supplements had a higher risk of developing serious SARs (OR: 1.60 [95% CI: 1.20-2.15]), as subjects exposed to 2-5 (OR: 1. 83 [95% CI: 1.30-2.58]) or more than 5 (OR: 3.45 [95% CI: 2.36-5.06]) suspect/interacting products. The probability of experiencing serious SAR was higher for subjects exposed to concomitant products (OR: 1.55 [95% CI: 1.15-2.08]), to more than four active compounds (OR: 4.38 [95% CI: 3.21-5.99]) and to SR for more than 14 days (OR: 1.89 [95% CI: 1.10-3, 22]), and lower for subjects exposed to higher doses of SR (OR: of 0.34 [95% CI: 0.20-0.58]). This evidence improves awareness on safety of SR containing products, suggesting the need of a further update of periodic reviews by national and international regulatory agencies.
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Affiliation(s)
- Giada Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
- Tuscan Regional Centre of Pharmacovigilance, Florence, Italy
| | - Valentina Maggini
- CERFIT, Research and Innovation Center in Phytotherapy and Integrated Medicine, Careggi University Hospital, Florence, Italy
| | - Emanuel Raschi
- Pharmacology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Nicoletta Luxi
- Department of Medicine, University of Verona, Verona, Italy
| | - Ilaria Ippoliti
- National Centre for Drug Research and Evaluation, Italian National Institute of Health, Rome, Italy
| | | | - Roberto Bonaiuti
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
- Tuscan Regional Centre of Pharmacovigilance, Florence, Italy
| | - Niccolò Firenzuoli
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Eugenia Gallo
- CERFIT, Research and Innovation Center in Phytotherapy and Integrated Medicine, Careggi University Hospital, Florence, Italy
| | | | - Ugo Moretti
- Department of Medicine, University of Verona, Verona, Italy
| | | | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
- Tuscan Regional Centre of Pharmacovigilance, Florence, Italy
| | - Fabio Firenzuoli
- CERFIT, Research and Innovation Center in Phytotherapy and Integrated Medicine, Careggi University Hospital, Florence, Italy
| | - Niccolò Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
- Tuscan Regional Centre of Pharmacovigilance, Florence, Italy
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Franco JV, Trivisonno L, Sgarbossa NJ, Alvez GA, Fieiras C, Escobar Liquitay CM, Jung JH. Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement. Cochrane Database Syst Rev 2023; 6:CD001423. [PMID: 37345871 PMCID: PMC10286776 DOI: 10.1002/14651858.cd001423.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate, which can lead to obstructive and irritative lower urinary tract symptoms (LUTS). The pharmacologic use of plants and herbs (phytotherapy) for the treatment of LUTS associated with BPH is common. The extract of the berry of the American saw palmetto or dwarf palm plant, Serenoa repens (SR), which is also known by its botanical name of Sabal serrulatum, is one of several phytotherapeutic agents available for the treatment of BPH. OBJECTIVES To assess the effects of Serenoa repens in the treatment of men with LUTS consistent with BPH. SEARCH METHODS We performed a comprehensive search of multiple databases (the Cochrane Library, MEDLINE, Embase, Scopus, Web of Science, and LILACS), trials registries, other sources of grey literature, and conference proceedings published up to 16 September 2022, with no restrictions on language or publication status. SELECTION CRITERIA We included randomized controlled trials of participants with BPH who were treated with Serenoa repens or placebo/no treatment. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion at each stage and undertook data extraction and risk of bias assessment and GRADE assessment of the certainty of the evidence. We considered review outcomes measured up to 12 months after randomization as short term, and beyond 12 months as long term. Our main outcomes included urologic symptom scores, quality of life, and adverse events. MAIN RESULTS For this update, we narrowed the review question to only comparisons with placebo. We included 27 studies (of which 9 were new) involving a total of 4656 participants, 19 studies comparing Serenoa repens with placebo, and 8 studies comparing Serenoa repens in combination with other phytotherapeutic agents versus placebo. Most studies included men aged > 50 (mean age range 52 to 68) with moderate urologic symptoms (International Prostate Symptom Score [IPSS] range 8 to 19). Ten studies were funded by the pharmaceutical industry; two studies were funded by government agencies; and the remaining studies did not specify funding sources. Serenoa repens versus placebo or no intervention Results for this comparison are based on predefined sensitivity analyses limited to studies at low risk of bias. Serenoa repens results in little to no difference in urologic symptoms at short-term follow-up (3 to 6 months; IPSS score range 0 to 35, higher scores indicate worse symptoms; mean difference (MD) -0.90, 95% confidence interval (CI) -1.74 to -0.07; I2 = 68%; 9 studies, 1681 participants; high-certainty evidence). Serenoa repens results in little to no difference in the quality of life at short-term follow-up (3 to 6 months; IPSS quality of life domain range 0 to 6, higher scores indicate worse quality of life; MD -0.20, 95% CI -0.40 to -0.00; I2 = 39%; 5 studies, 1001 participants; high-certainty evidence). Serenoa repens probably results in little to no difference in adverse events (1 to 17 months; risk ratio (RR) 1.01, 95% CI 0.77 to 1.31; I2 = 18%; 12 studies, 2399 participants; moderate-certainty evidence). Based on 164 cases per 1000 men in the placebo group, this corresponds to 2 more (38 fewer to 51 more) per 1000 men in the Serenoa repens group. Serenoa repens results in little to no difference in urologic symptoms at long-term follow-up (12 to 17 months, IPSS score, MD 0.07, 95% CI -0.75 to 0.88; I2 = 34%; 3 studies, 898 participants; high-certainty evidence). Serenoa repens results in little to no difference in quality of life at long-term follow-up (12 to 17 months, IPSS quality of life, MD -0.11, 95% CI -0.41 to 0.19; I2 = 65%; 3 studies, 882 participants; high-certainty evidence). There were no data on long-term adverse events for this comparison. Serenoa repens in combination with other phytotherapy versus placebo or no intervention Different phytotherapeutic agents that include Serenoa repens may result in little to no difference in urologic symptoms compared to placebo at short-term follow-up (12 to 24 weeks, IPSS score, MD -2.41, 95% CI -4.54 to -0.29; I2 = 67%; 4 studies, 460 participants; low-certainty evidence). We are very uncertain about the effects of these agents on quality of life (very low-certainty evidence). These agents may result in little to no difference in the occurrence of adverse events; however, the CIs included substantial benefits and harms (12 to 48 weeks, RR 0.91, 95% CI 0.58 to 1.41; I2 = 0%; 4 studies, 481 participants; low-certainty evidence). Based on 132 cases per 1000 men in the placebo group, this corresponds to 12 fewer (55 fewer to 54 more) per 1000 men in the combined phytotherapeutic agents with Serenoa repens group. AUTHORS' CONCLUSIONS Serenoa repens alone provides little to no benefits for men with lower urinary tract symptoms due to benign prostatic enlargement. There is more uncertainty about the role of Serenoa repens in combination with other phytotherapeutic agents.
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Affiliation(s)
- Juan Va Franco
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Leonel Trivisonno
- Department of Health Science, Universidad Nacional de La Matanza, San Justo, Argentina
| | - Nadia J Sgarbossa
- Department of Health Science, Universidad Nacional de La Matanza, San Justo, Argentina
| | - Gustavo Ariel Alvez
- Medical School, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Fieiras
- Medical School, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Jae Hung Jung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea, South
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Ocampo Arango CM, Cañas Ángel Z, Carazzone C, Largo Ávila E, Martínez Álvarez OL, Mutis González JS. Effect of solar drying on physical, chemical, and sensory properties of
Cymbopogon citratus
grown in Antioquia ‐ Colombia. J FOOD PROCESS ENG 2023. [DOI: 10.1111/jfpe.14252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Carlos Mario Ocampo Arango
- Sensory Science Research Group, Pharmaceutical and Food Sciences Faculty Universidad de Antioquia UdeA Medellín Antioquia Colombia
| | - Zoraida Cañas Ángel
- Sensory Science Research Group, Pharmaceutical and Food Sciences Faculty Universidad de Antioquia UdeA Medellín Antioquia Colombia
| | - Chiara Carazzone
- Laboratory of Advanced Analytical Techniques in Natural Products, Chemistry Department Universidad de los Andes Bogotá D.C. Colombia
| | - Esteban Largo Ávila
- Sensory Science Research Group, Pharmaceutical and Food Sciences Faculty Universidad de Antioquia UdeA Medellín Antioquia Colombia
- Universidad del Valle Caicedonia Regional Campus Caicedonia Colombia
| | - Olga Lucia Martínez Álvarez
- Sensory Science Research Group, Pharmaceutical and Food Sciences Faculty Universidad de Antioquia UdeA Medellín Antioquia Colombia
| | - Juan Sebastián Mutis González
- Laboratory of Advanced Analytical Techniques in Natural Products, Chemistry Department Universidad de los Andes Bogotá D.C. Colombia
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Bakhaidar RB, Hosny KM, Mahier IM, Rizq WY, Safhi AY, Bukhary DM, Sultan MH, Bukhary HA, Madkhali OA, Sabei FY. Development and optimization of a tamsulosin nanostructured lipid carrier loaded with saw palmetto oil and pumpkin seed oil for treatment of benign prostatic hyperplasia. Drug Deliv 2022; 29:2579-2591. [PMID: 35915055 PMCID: PMC9477485 DOI: 10.1080/10717544.2022.2105448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Benign prostatic hyperplasia (BPH) is a nonmalignant growth of the prostate tissue and causes urinary tract symptoms. To provide effective treatment, tamsulosin (TM), saw palmetto oil (SP), and pumpkin seed oil (PSO) were combined and fabricated a nanostructured lipid carrier (NLC) as TM-S/P-NLC using experimental design. The purpose was to enhance the permeation and therapeutic activity of TM; combining TM with SP and PSO in an NLC generates a synergistic activity. An optimized TM-S/P-NLC was obtained after statistical analysis, and it had a particle size, percentage of entrapment efficiency, and steady-state flux of 102 nm, 65%, and 4.5 μg/cm2.min, respectively. Additionally, the optimized TM-S/P-NLC had spherical particles with a more or less uniform size and a stability score of 95%, indicating a high level of stability. The in vitro release studies exhibited the optimized TM-S/P-NLC had the maximum release profile for TM (81 ± 4%) as compared to the TM-NLCs prepared without the addition of S/P oil (59 ± 3%) or the TM aqueous suspension (30 ± 5%). The plasma TM concentration–time profile for the TM-S/P-NLC and the marketed TM tablets indicated that when TM was supplied in a TM-S/P-NLC, the pharmacokinetic profile of the drug was improved. Simultaneously, in vivo therapeutic efficacy studies also showed favorable results for the TM-S/P-NLC in terms of the prostate weight and prostate index following treatment of BPH. Based on the findings of present study, we suggest that in the future, the TM-S/P-NLC could be a novel drug delivery system for treating BPH.
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Affiliation(s)
- Rana B Bakhaidar
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khaled M Hosny
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Imman M Mahier
- Department of Biotechnology, Cairo Clinical Laboratory Center, Cairo, Egypt
| | - Waleed Y Rizq
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Awaji Y Safhi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Deena M Bukhary
- Department of Pharmaceutics, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Muhammad H Sultan
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Haitham A Bukhary
- Department of Pharmaceutics, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Osama A Madkhali
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Fahad Y Sabei
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
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7
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Mata LRFD, Motter PGR, Azevedo C, Bernardes MFVG, Chianca TCM, Vasques CI. Complementary therapies in the control of male lower urinary tract symptoms: A systematic review. Rev Lat Am Enfermagem 2022; 30:e3597. [PMID: 35858004 DOI: 10.1590/1518-8345.5897.3597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/26/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to evaluate diverse scientific evidence on the effectiveness of complementary therapies in the control of lower urinary tract symptoms in the adult and aged male population. METHOD a systematic review developed according to the PRISMA checklist. The search was performed in the CINAHL, Embase, LILACS, PEDro, PubMed, Web of Science and Google Scholar databases. RESULTS a total of 585 records were identified and 12 clinical trials were selected that met the inclusion criteria. The outcomes considered by the studies for analyzing effectiveness of the complementary therapies were validated questionnaires to assess the severity of the lower urinary tract symptoms (sensation of incomplete bladder emptying, frequent urination, intermittent flow, weak flow, pain or difficulty urinating, nocturia and urgency) and urodynamics parameters. The studies analyzed the complementary phytotherapy (n=8) and electroacupuncture (n=4) therapies. Six studies related to phytotherapy showed statistical significance. Electroacupuncture showed a significant improvement in the symptoms in two studies. CONCLUSION pytotherapy was effective to control the simptoms related to frequency, urgency, nocturia, incomplete emptying, intermittence, weak flow and effort to initiate urination. To confirm the effectiveness of electroacupuncture, research studies with well-designed methodologies will also be necessary to resolve the divergences between the studies of this review.
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Affiliation(s)
| | | | - Cissa Azevedo
- Universidade Federal de Viçosa, Departamento de Medicina e Enfermagem, Viçosa, MG, Brasil
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8
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Mata LRFD, Motter PGR, Azevedo C, Bernardes MFVG, Chianca TCM, Vasques CI. Complementary therapies in the control of male lower urinary tract symptoms: A systematic review. Rev Lat Am Enfermagem 2022. [PMID: 35858004 PMCID: PMC9285198 DOI: 10.1590/1518-8345.5897.3543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: to evaluate diverse scientific evidence on the effectiveness of complementary therapies in the control of lower urinary tract symptoms in the adult and aged male population. Method: a systematic review developed according to the PRISMA checklist. The search was performed in the CINAHL, Embase, LILACS, PEDro, PubMed, Web of Science and Google Scholar databases. Results: a total of 585 records were identified and 12 clinical trials were selected that met the inclusion criteria. The outcomes considered by the studies for analyzing effectiveness of the complementary therapies were validated questionnaires to assess the severity of the lower urinary tract symptoms (sensation of incomplete bladder emptying, frequent urination, intermittent flow, weak flow, pain or difficulty urinating, nocturia and urgency) and urodynamics parameters. The studies analyzed the complementary phytotherapy (n=8) and electroacupuncture (n=4) therapies. Six studies related to phytotherapy showed statistical significance. Electroacupuncture showed a significant improvement in the symptoms in two studies. Conclusion: pytotherapy was effective to control the simptoms related to frequency, urgency, nocturia, incomplete emptying, intermittence, weak flow and effort to initiate urination. To confirm the effectiveness of electroacupuncture, research studies with well-designed methodologies will also be necessary to resolve the divergences between the studies of this review.
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9
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Mata LRFD, Motter PGR, Azevedo C, Bernardes MFVG, Chianca TCM, Vasques CI. Terapias complementarias para el control de los síntomas del tracto urinario inferior masculino: revisión sistemática. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5897.3596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: evaluar la evidencia científica sobre la efectividad de las terapias complementarias para el control de los síntomas del tracto urinario inferior en la población masculina adulta y adulta mayor. Método: revisión sistemática desarrollada según la checklist PRISMA. La búsqueda se realizó en las bases de datos CINAHL, Embase, LILACS, PEDro, PubMed, Web of Science y Google Scholar. Resultados: se identificaron 585 registros y se seleccionaron 12 ensayos clínicos que cumplían con los criterios de inclusión. Los resultados que los estudios consideraron para analizar la efectividad de las terapias complementarias fueron cuestionarios validados que evaluaban la gravedad de los síntomas del tracto urinario inferior (sensación de vaciado incompleto de la vejiga, micción frecuente, flujo intermitente, flujo débil, dolor o dificultad para orinar, nicturia y urgencia) y parámetros urodinámicos. Los estudios analizaron las terapias complementarias fitoterapia (n=8) y electroacupuntura (n=4). Seis estudios relacionados con la fitoterapia demostraron significación estadística. La electroacupuntura demostró una mejoría significativa de los síntomas en dos estudios. Conclusión: la fitoterapia fue efectiva para controlar los síntomas de frecuencia, urgencia, nicturia, vaciado incompleto, intermitencia, flujo débil y esfuerzo para iniciar la micción. Para confirmar la efectividad de la electroacupuntura, aún es necesario que se realicen investigaciones con metodologías bien diseñadas para resolver las diferencias entre los estudios de esta revisión.
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10
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Paulis G, Paulis A, Perletti G. Serenoa repens and its effects on male sexual function. A systematic review and meta-analysis of clinical trials. Arch Ital Urol Androl 2021; 93:475-480. [PMID: 34933534 DOI: 10.4081/aiua.2021.4.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Serenoa repens (SR) is a plant used to treat benign prostatic hyperplasia and prostatitis. We know that SR act as a 5α-reductase inhibitor, moreover, several studies have proved that SR has anti-inflammatory and antioxidant properties. There is some belief among patients that SR may negatively impact male sexual function. Such belief is circulating in non-medical social networks and is perhaps maintained by patients as a result of incorrect web surfing. However, it is also possible that SR may exert a "nocebo" effect thus negatively impacting on the general well-being of patients. OBJECTIVE The aim of this study is to investigate whether SR is causing negative effects on male sexual function. METHODS To ascertain the effect of SR on male sexual function, we conducted a systematic review and meta-analysis, by performing an electronic database search in accordance with the PRISMA guidelines. RESULTS Out of 20 included papers, 8 papers reported comparisons of SR with placebo, and 7 studies reported comparisons of SR with tamsulosin. The standardized mean difference of changes from baseline scores of sexual function was not significantly different between SR and placebo (SMD: 0.43, 95% CI: 0.18 to 1.05; I^2 = 95%). Similarly, no significant mean differences in the Male Sexual Function-4 (MSF-4) test scores were found between SR and tamsulosin (SMD: -0.31, 95% CI: -0.82 to 0.19; I^2 = 90%). CONCLUSIONS We found no statistically significant differences between negative effects on sexual function in patients treated with SR compared to patients who received placebo. The results of our meta-analysis are similar to those of other systematic reviews. Studies are warranted to ascertain whether any such effects might occur as a result of a nocebo effect.
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Affiliation(s)
- Gianni Paulis
- Department of Uro-Andrology, Castelfidardo Medical Team, Rome.
| | - Andrea Paulis
- Neurosystem Center for applied Psychology and Neuroscience, Janet Clinical Centre, Rome.
| | - Gianpaolo Perletti
- Faculty of Medicine and Medical Sciences, Ghent University, Belgium; Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
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11
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Liu M, Yin H, Wang F, Tian Y. The Therapeutic Potential of Saw Palmetto Extract in Urological Disorders. Nat Prod Commun 2021. [DOI: 10.1177/1934578x211059635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Saw palmetto extract (SPE) has been widely used as a therapeutic remedy for urinary dysfunction in western countries. Furthermore, as an herb drug, it can be used as an alternative therapy for benign prostatic hyperplasia (BPH) due to its safety and minimum adverse effects. Reportedly, SPE improves the urinary symptoms, which mainly depend on anti-androgenic effects and effects on autonomic receptors in the lower urinary tract. However, the mechanisms of action responsible for the therapeutic roles of SPE have not been fully elucidated. Relevant studies indicate that SPE has some positive effects on the treatment of urological diseases in animals, and clinical trials are ongoing. In this review, we summarize the pharmacological properties and discuss the possible therapeutic mechanisms of SPE in urological diseases, including anti-androgenic effects, effects on autonomic receptors in the lower urinary tract, anti-inflammatory activity, anti-proliferative and pro-apoptotic effects, and highlight a potential therapeutic approach in the clinical treatment of patients with BPH, prostate cancer, chronic prostatitis (CP) and erectile dysfunction (ED).
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Affiliation(s)
- Meng Liu
- Second Military Medical University, Shanghai, China
| | - Huirong Yin
- Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Fang Wang
- Second Military Medical University, Shanghai, China
| | - Ying Tian
- Hebei Reproductive Hospital, Shijiazhuang, China
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12
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Sakalis V, Gkotsi A, Charpidou D, Tsafrakidis P, Apostolidis A. The effect of pharmacotherapy on prostate volume, prostate perfusion and prostate-specific antigen (prostate morphometric parameters) in patients with lower urinary tract symptoms and benign prostatic obstruction. A systematic review and meta-analysis. Cent European J Urol 2021; 74:388-421. [PMID: 34729231 PMCID: PMC8552938 DOI: 10.5173/ceju.2021.132.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/15/2021] [Accepted: 06/30/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction The clinical effect of pharmacotherapy on prostate morphometric parameters is largely unknown. The sole exception is 5α-reductase inhibitors (5-ARI) that reduce prostate volume and prostate-specific antigen (PSA). This review assesses the effect of pharmacotherapy on prostate parameters effect on prostate parameters, namely total prostate volume (TPV), transitional zone volume (TZV), PSA and prostate perfusion. Material and methods We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) reporting on morphometric parameters’ changes after pharmacotherapy, as primary or secondary outcomes. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RCTs’ quality was assessed by the Cochrane tool and the criteria of the Agency for Healthcare Research and Quality. The effect magnitude was expressed as standard mean difference (SMD). The study protocol was published on PROSPERO (CRD42020170172). Results Sixty-seven RCTs were included in the review and 18 in the meta-analysis. The changes after alpha-blockers are comparable to placebo. Long-term studies reporting significant changes from baseline, result from physiologic growth. Finasteride and dutasteride demonstrated large effect sizes in TPV reduction ([SMD]: -1.15 (95% CI: -1.26 to -1.04, p <0.001, and [SMD]:-0.66 (95% CI: -0.83 to -0.49, p <0.001, respectively), and similar PSA reductions. Dutasteride’s effect appears earlier (1st vs 3rd month), the changes reach a maximum at month 12 and are sustained thereafter. Phosphodiesterase-5 (PDE-5) inhibitors have no effect on morphometric parameters. Phytotherapy’s effect on TPV is non-significant [SMD]: 0.12 (95% CI: -0.03 to 0.27, p = 0.13). Atorvastatin reduces TPV as compared to placebo (-11.7% vs +2.5%, p <0.01). Co-administration of testosterone with dutasteride spares the prostate from the androgenic stimulation as both TPV and PSA are reduced significantly. Conclusions The 5-ARIs show large effect size in reducing TPV and PSA. Tamsulosin improves perfusion but no other effect is evident. PDE-5 inhibitors and phytotherapy do not affect morphometric parameters. Atorvastatin reduces TPV and PSA as opposed to testosterone supplementation.
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Affiliation(s)
- Vasileios Sakalis
- Department of Urology, Agios Pavlos General Hospital of Thessaloniki, Thessaloniki, Greece.,2 Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Gkotsi
- Department of Urology, Agios Pavlos General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Charpidou
- Department of Urology, Agios Pavlos General Hospital of Thessaloniki, Thessaloniki, Greece
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13
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Qiao J, Gan Y, Gong Y, Song Q, Zhang B, Li B, Ru F, Li Y, He Y. Combination therapy with curcumin plus tamsulosin and finasteride in the treatment of men with benign prostatic hyperplasia: a single center, randomized control study. Transl Androl Urol 2021; 10:3432-3439. [PMID: 34532268 PMCID: PMC8421839 DOI: 10.21037/tau-21-567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/02/2021] [Indexed: 11/06/2022] Open
Abstract
Background To perform a prospective, randomized, single center study to investigate the efficacy of combined use of curcumin, an anti-inflammatory agent, with the best standard management (BSM, tamsulosin and finasteride) in benign prostatic hyperplasia (BPH) patients. Methods One hundred and twenty-two consecutive patients were randomized to receive tamsulosin 0.2 mg, finasteride 5 mg, and curcumin 2,250 mg once a day (curcumin + BSM group, n=61) versus tamsulosin 0.2 mg, finasteride 5 mg, and placebo (BSM group, n=61) for 6 months. The safety of treatments and their efficacy on improving waist circumference (WC), periprostatic fat thickness (PPFT), lower urinary tract symptoms (LUTS), and sexual function were assessed at baseline and month 6. Results One hundred and sixteen patients completed the whole procedure (116/122, 95.1%). There were significant improvements in prostate volume (PV), maximum flow rate (Qmax), the International Prostate Symptom Score (IPSS), IPSS-voiding subscore (IPSS-V), IPSS-storage subscore (IPSS-S), and quality of life (QoL) from baseline after treatment in both groups. Additionally, both WC and PPFT decreased significantly after treatments than those at baseline in the curcumin + BSM group. Also, WC and PPFT in the curcumin + BSM group were significantly lower than those in the BSM group. In addition, IPSS-S, QoL score, and the 5-item version of the International Index of Erectile Function (IIEF-5) in the curcumin + BSM group improved significantly compared with those in the BSM group. Conclusions We conclude that curcumin combined with tamsulosin and finasteride has more beneficial effects in reducing PPFT, protecting erectile function, improving urinary retention symptoms, and QoL scores in BPH patients compared to tamsulosin and finasteride alone. Trial Registration Chinese Clinical Trial Registry ChiCTR2100043800.
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Affiliation(s)
- Jing Qiao
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China
| | - Yu Gan
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yuchen Gong
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Qingtian Song
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Bo Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Bingsheng Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Feng Ru
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yao He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
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14
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Trivisonno LF, Sgarbossa N, Alvez GA, Fieiras C, Escobar Liquitay CM, Jung JH, Franco JVA. Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement: A systematic review and meta-analysis. Investig Clin Urol 2021; 62:520-534. [PMID: 34488251 PMCID: PMC8421998 DOI: 10.4111/icu.20210254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 08/05/2021] [Indexed: 12/04/2022] Open
Abstract
PURPOSE To assess the effects of Serenoa repens alone or in combination with other phytotherapy compared to placebo in men with LUTS due to benign prostatic enlargement. MATERIALS AND METHODS Following a registered protocol (CRD42021226655), we searched (December 2020) MEDLINE, CENTRAL, Embase, ClinicalTrials.gov, WHO-ICTRP trials platform and other sources with no restrictions on language, publication date or status. We included randomized controlled trials, and we critically appraised them using the Cochrane Tool for Risk of Bias Assessment (RoB 2). We conducted random-effects meta-analysis when appropriate. The primary outcomes included urinary symptoms score, quality of life, and adverse events. The certainty of the evidence was rated using GRADE. RESULTS We included 27 trials with 4,853 participants. S. repens results in little to no difference in urinary symptoms, quality of life, and adverse events at short- and long-term follow-up. S. repens combined with other phytotherapy may slightly reduce urinary symptoms at short-term follow-up, but the results are uncertain. The results on quality of life and adverse events are also very uncertain. CONCLUSIONS S. repens alone may result in no clinical benefits for men with LUTS. There is greater uncertainty in the effects of S. repens in combination with other phytotherapy.
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Affiliation(s)
| | - Nadia Sgarbossa
- Department of Health Science, Universidad Nacional de La Matanza, San Justo, Buenos Aires, Argentina
| | - Gustavo Ariel Alvez
- Department of Research, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Fieiras
- Department of Research, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Jae Hung Jung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea
| | - Juan Víctor Ariel Franco
- Department of Health Science, Universidad Nacional de La Matanza, San Justo, Buenos Aires, Argentina
- Department of Research, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
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15
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Spivak L, Morozov A, Shpikina A, Enikeev D, Rapoport L. Postoperative medical treatment of lower urinary tract symptoms after benign prostatic hyperplasia surgery. Are we underestimating the problem? Curr Opin Urol 2021; 31:451-455. [PMID: 34175875 DOI: 10.1097/mou.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The aim of this study was to determine whether well timed start of medical and surgical treatment of benign prostatic obstruction (BPO) influences the treatment's effectiveness and thus the patients' overall functional outcomes and quality of life. RECENT FINDINGS Pharmacological therapy even in high-volume (>80 cm3) BPH typically begins with α-blockers sole and only subsequently are 5ARI added. Several studies showed that acute urinary retention (AUR) developed more frequently in men who suffered severe lower urinary tract symptoms (LUTS) and who did not start combination therapy immediately. Moreover, there are no strict criteria which determine the right time for performing surgery in patients with mild and moderate LUTS, especially when pharmacological therapy fails. However, sometimes, the surgery does not eliminate all the symptoms, as it deals effectively with BPO, but does not treat an overactive bladder. Also, data show that surgery should be performed as soon as possible and be more radical after the first episode of AUR. SUMMARY A combination of α-blockers and 5ARI makes for a good starting point where the treatment of high volume BPH is concerned. Ideally, surgery should be performed immediately or as soon as possible in patients with the first episode of AUR and 'anatomic' BPH tissue removal is preferable (dissection of tissue along the prostate capsule to remove its maximum volume).
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Affiliation(s)
| | | | - Anastasia Shpikina
- International School 'Medicine of the Future', Sechenov University, Moscow, Russia
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16
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Zhang K, Guo RQ, Chen SW, Chen B, Xue XB, Chen S, Huang J, Liu M, Tian Y, Zuo L, Chen M, Zhou LQ. The efficacy and safety of Serenoa repens extract for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized, double-blind, placebo-controlled trial. World J Urol 2021; 39:3489-3495. [PMID: 33452912 PMCID: PMC8510895 DOI: 10.1007/s00345-020-03577-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/19/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose To perform a placebo-controlled trial to evaluate the efficacy and safety of Serenoa repens extract (SRE) for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods We conducted a double-blind, randomized, placebo-controlled, multicenter, clinical phase 4 study of 221 patients with CP/CPPS across 11 centers. Participants were randomly assigned in a 2:1 ratio to receive SRE or placebo for 12 weeks. The primary efficacy endpoint was the change in total score on the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). Secondary efficacy endpoints included improvements within each domain of NIH-CPSI, clinical response rate, and International Index of Erectile Function 5 items (IIEF-5). Results In total, 226 patients were enrolled and randomized between January 2017 and June 2018. Of these 221 patients were included in the intent-to-treat analysis: 148 in the SRE group and 73 patients in the placebo group. Compared to the placebo, SRE led to statistically significant improvements in the NIH-CPSI total score and sub-scores. The significant improvements of NIH-CPSI scores were established after 2 weeks from the first dose, and continued to the end of the treatment. Furthermore, a significantly higher rate of patients achieved a clinical response in the SRE group compared with that in the placebo group (73.0% vs 32.9%, P < 0.0001). Only minor adverse events were observed across the entire study population. Conclusions SRE was effective, safe, and clinically superior to placebo for the treatment of CP/CPPS. ChiCTR-IPR-16010196, December 21, 2016 retrospectively registered Supplementary Information The online version contains supplementary material available at 10.1007/s00345-020-03577-2.
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Affiliation(s)
- Kai Zhang
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, Beijing, 100034, China.,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China
| | - Run-Qi Guo
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Shan-Wen Chen
- Department of Urology, Huashan Hospital of Fudan University, Shanghai, China
| | - Bin Chen
- Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xin-Bo Xue
- Department of Urology, The Second Affiliated Hospital, Soochow University, Suzhou, China
| | - Shan Chen
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jian Huang
- Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ming Liu
- Department of Urology, Beijing Hospital, Beijing, China
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Li Zuo
- Department of Urology, Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China
| | - Ming Chen
- Department of Urology, Zhongda Hospital, Southeast University, Nanjing, 210000, Jiangsu, China.
| | - Li-Qun Zhou
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, Beijing, 100034, China. .,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China.
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17
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Sudeep HV, Thomas JV, Shyamprasad K. A double blind, placebo-controlled randomized comparative study on the efficacy of phytosterol-enriched and conventional saw palmetto oil in mitigating benign prostate hyperplasia and androgen deficiency. BMC Urol 2020; 20:86. [PMID: 32620155 PMCID: PMC7333342 DOI: 10.1186/s12894-020-00648-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
Background The present clinical trial was conducted to evaluate the efficacy and tolerability of a standardized saw palmetto oil containing 3% β-sitosterol in the treatment of benign prostate hyperplasia (BPH) and androgen deficiency. Methods Subjects aged 40–65 years with symptomatic BPH were randomized to 12-week double-blind treatment with 500 mg doses of β-sitosterol enriched saw palmetto oil, conventional saw palmetto oil and placebo orally in the form of capsules (n = 33 in each group). BPH severity was determined using the International Prostate Symptom Score (IPSS), uroflowmetry, serum measurement of prostate specific antigen (PSA), testosterone and 5α-reductase. During the trial, the androgen deficiency was evaluated using Aging Male Symptoms (AMS) scale, the Androgen Deficiency in the Aging Male (ADAM) questionnaire, serum levels of free testosterone. Results Subjects treated with β-sitosterol enriched saw palmetto oil showed significant decrease in IPSS, AMS and ADAM scores along with reduced postvoiding residual volume (p < 0.001), PSA (p < 0.01) and 5α-reductase from baseline to end of 12-week treatment as compared to placebo. There was also a significant increment in the maximum and average urine flow rate (p < 0.001), and serum free testosterone level of subjects treated with enriched saw palmetto oil as compared to placebo. Conclusion This study demonstrates the efficacy of β-sitosterol enriched saw palmetto oil superior to conventional oil thus extending the scope of effective BPH and androgen deficiency treatment with improved quality of life through the intake of functional ingredients. Trial registration CTRI/2018/12/016724 dated 19/12/2018 prospectively registered. URL: http://ctri.nic.in/Clinicaltrials/advsearch.php
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Affiliation(s)
- H V Sudeep
- R&D Center for Excellence, Vidya Herbs Pvt. Ltd, #14A, Jigani I phase, Bangalore, Karnataka, 560 105, India. .,Leads Clinical Research and Bio services Private Ltd., Bangalore, India.
| | - Jestin V Thomas
- Leads Clinical Research and Bio services Private Ltd., Bangalore, India
| | - K Shyamprasad
- R&D Center for Excellence, Vidya Herbs Pvt. Ltd, #14A, Jigani I phase, Bangalore, Karnataka, 560 105, India
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18
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Phytopharmacological Possibilities of Bird Cherry Prunus padus L. and Prunus serotina L. Species and Their Bioactive Phytochemicals. Nutrients 2020; 12:nu12071966. [PMID: 32630652 PMCID: PMC7399899 DOI: 10.3390/nu12071966] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 12/12/2022] Open
Abstract
Wild cherry is a plant observed in the form of trees or shrubs. This species comprises about twenty kinds of plants and the most popular are two, Prunus padus L. and Prunus serotina L., whose properties and content of phytochemical compounds are subject to studies. Wild cherry contains many active compounds, including tocopherols, vitamins, polyphenols and terpenes, which can have beneficial effects on health. On the other hand, wild cherry contains cyanogenic glycosides. Nevertheless, current research results indicate pro-health properties associated with both P. serotina and P. padus. The aim of this study was to collect and present the current state of knowledge about wild cherry and to review available in vitro and in vivo studies concerning its antioxidant, anti-inflammatory, antibacterial and antidiabetic activity. Moreover, the current work presents and characterizes phytochemical content in the leaves, bark and fruits of P. padus and P. serotina and compiles data that indicate their health-promoting and functional properties and possibilities of using them to improve health. We find that the anatomical parts of P. padus and P. serotina can be a valuable raw material used in the food, pharmaceutical and cosmetic industries as a source of bioactive compounds with multi-directional action.
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Ullah R, Wazir J, Hossain MA, Diallo MT, Khan FU, Ihsan AU, Zhou X. A glimpse into the efficacy of alternative therapies in the management of benign prostatic hyperplasia. Wien Klin Wochenschr 2020; 133:153-162. [PMID: 32533441 DOI: 10.1007/s00508-020-01692-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/26/2020] [Indexed: 12/28/2022]
Abstract
Benign prostatic hyperplasia (BPH) is a common disease that can cause uncomfortable lower urinary tract symptoms. The occurrence of symptomatic BPH develops after the age of 40 years and increases gradually with age to reach more than 50% at the age of 60 years and severely disturbs the quality of life of the patients. Alpha-blockers and 5‑alpha reductase inhibitors are first-line agents used for the treatment of BPH. Due to the adverse effects of these conventional therapies, many patients turn to phytotherapy and other alternative therapies. This review covers alternative therapies, i.e., phytotherapy (cernilton, eviprostat, quercetin, saw palmetto and pumpkin seed) and physical therapy (acupuncture, aquablation, pulsed electromagnetic field, prostate urethral lift, radial extracorporeal shock wave therapy, thermobalancing therapy, and transurethral needle ablation) commonly used in the management of BPH.
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Affiliation(s)
- Rahat Ullah
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 211198, Nanjing, Jiangsu, China
| | - Junaid Wazir
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 211198, Nanjing, Jiangsu, China
| | - Md Amir Hossain
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, 211198, Nanjing, Jiangsu, China
| | - Maladho Tanta Diallo
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 211198, Nanjing, Jiangsu, China
| | - Farhan Ullah Khan
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 211198, Nanjing, Jiangsu, China
| | - Awais Ullah Ihsan
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 211198, Nanjing, Jiangsu, China
| | - Xiaohui Zhou
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 211198, Nanjing, Jiangsu, China.
- Department of Surgery, Nanjing Shuiximen Hospital, 211198, Nanjing, Jiangsu, China.
- Zhongda Hospital, Affiliated with Southeast University, 211198, Nanjing, Jiangsu, China.
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