The Journal of Urology
Volume 179, Issue 6 , Pages 2119-2125 , June 2008

Phytotherapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

  • Raj C. Dedhia
  • ,
  • Kevin T. McVary

      Affiliations

    • Corresponding Author InformationCorrespondence: Department of Urology, Northwestern University Feinberg School of Medicine, Tarry 16-749, 303 East Chicago Ave., Chicago, Illinois 60611 (telephone: 312-908-8600; FAX: 312-908-7275).
    • Financial interest and/or other relationship with Sanofi Aventis Medical, GlaxoSmithKline, Lilly-ICOS, Beckman Coulter and National Institute for Diabetes and Digestive and Kidney Diseases.

Received 17 August 2007

References 

  1. Bales GT, Christiano AP, Kirsh EJ, Gerber GS. Phytotherapeutic agents in the treatment of lower urinary tract symptoms: a demographic analysis of awareness and use at the University of Chicago. Urology. 1999;54:86
  2. Buck AC. Is there a scientific basis for the therapeutic effects of serenoa repens in benign prostatic hyperplasia? (Mechanisms of action). J Urol. 2004;172:1792
  3. Weisser H, Tunn S, Behnke B, Krieg M. Effects of the sabal serrulata extract IDS 89 and its subfractions on 5 alpha-reductase activity in human benign prostatic hyperplasia. Prostate. 1996;28:300
  4. Hill B, Kyprianou N. Effect of permixon on human prostate cell growth: lack of apoptotic action. Prostate. 2004;61:73
  5. Rhodes L, Primka RL, Berman C, Vergult G, Gabriel M, Pierre-Malice M, et al. Comparison of finasteride (Proscar), a 5 alpha reductase inhibitor, and various commercial plant extracts in in vitro and in vivo 5 alpha reductase inhibition. Prostate. 1993;22:43
  6. Vacherot F, Azzouz M, Gil-Diez-De-Medina S, Colombel M, De La Taille A, Lefrere Belda MA, et al. Induction of apoptosis and inhibition of cell proliferation by the lipido-sterolic extract of Serenoa repens (LSESr, Permixon®) in benign prostatic hyperplasia. Prostate. 2000;45:259
  7. Vela-Navarrete R, Escribano-Burgos M, Farre AL, Garcia-Cardoso J, Manzarbeitia F, Carrasco C. Serenoa repens treatment modifies bax/bcl-2 index expression and caspase-3 activity in prostatic tissue from patients with benign prostatic hyperplasia. J Urol. 2005;173:507
  8. Goepel M, Hecker U, Krege S, Rubben H, Michel MC. Saw palmetto extracts potently and noncompetitively inhibit human alpha1-adrenoceptors in vitro. Prostate. 1999;38:208
  9. Goepel M, Dinh L, Mitchell A, Schafers RF, Rubben H, Michel MC. Do saw palmetto extracts block human alpha1-adrenoceptor subtypes in vivo?. Prostate. 2001;46:226
  10. Cao N, Haynes JM, Ventura S. Saw palmetto is an indirectly acting sympathomimetic in the rat-isolated prostate gland. Prostate. 2006;66:115
  11. Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA. 1998;280:1604
  12. Boyle P, Robertson C, Lowe F, Roehrborn C. Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU Int. 2004;93:751
  13. Lowe FC, Dreikorn K, Borkowski A, Braeckman J, Denis L, Ferrari P, et al. Review of recent placebo-controlled trials utilizing phytotherapeutic agents for treatment of BPH. Prostate. 1998;37:187
  14. Gerber GS, Kuznetsov D, Johnson BC, Burstein JD. Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms. Urology. 2001;58:960
  15. Willetts KE, Clements MS, Champion S, Ehsman S, Eden JA. Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial. BJU Int. 2003;92:267
  16. Bent S, Kane C, Shinohara K, Neuhaus J, Hudes ES, Goldberg H, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med. 2006;354:557
  17. Wilt T, Ishani A, MacDonald R. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2002;CD001423
  18. Cheema P, El-Mefty O, Jazieh AR. Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature. J Intern Med. 2001;250:167
  19. Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J. 2006;99:611
  20. Ishani A, MacDonald R, Nelson D, Rutks I, Wilt TJ. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med. 2000;109:654
  21. Boulbes D, Soustelle L, Costa P, Haddoum M, Bali JP, Hollande F, et al. Pygeum africanum extract inhibits proliferation of human cultured prostatic fibroblasts and myofibroblasts. BJU Int. 2006;98:1106
  22. Lawson RK. Role of growth factors in benign prostatic hyperplasia. Eur Urol. 1997;32:22
  23. Paubert-Braquet M, Cave A, Hocquemiller R, Delacroix D, Dupont C, Hedef N, et al. Effect of Pygeum africanum extract on A23187-stimulated production of lipoxygenase metabolites from human polymorphonuclear cells. J Lipid Mediat Cell Signal. 1994;9:285
  24. Choo MS, Bellamy F, Constantinou CE. Functional evaluation of Tadenan on micturition and experimental prostate growth induced with exogenous dihydrotestosterone. Urology. 2000;55:292
  25. Yoshimura Y, Yamaguchi O, Bellamy F, Constantinou CE. Effect of Pygeum africanum tadenan on micturition and prostate growth of the rat secondary to coadministered treatment and post-treatment with dihydrotestosterone. Urology. 2003;61:474
  26. Melo EA, Bertero EB, Rios LA, Mattos D. Evaluating the efficiency of a combination of Pygeum africanum and stinging nettle (Urtica dioica) extracts in treating benign prostatic hyperplasia (BPH): double-blind, randomized, placebo controlled trial. Int Braz J Urol. 2002;28:418
  27. Chatelain C, Autet W, Brackman F. Comparison of once and twice daily dosage forms of Pygeum africanum extract in patients with benign prostatic hyperplasia: a randomized, double-blind study, with long-term open label extension. Urology. 1999;54:473
  28. MacDonald R, Ishani A, Rutks I, Wilt TJ. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. BJU Int. 2000;85:836
  29. Habib FK, Ross M, Buck AC, Ebeling L, Lewenstein A. In vitro evaluation of the pollen extract, cernitin T-60, in the regulation of prostate cell growth. Br J Urol. 1990;66:393
  30. Kimura M, Kimura I, Nakase K, Sonobe T, Mori N. Micturition activity of pollen extract: contractile effects on bladder and inhibitory effects on urethral smooth muscle of mouse and pig. Planta Med. 1986;52:148
  31. Talpur N, Echard B, Bagchi D, Bagchi M, Preuss HG. Comparison of Saw Palmetto (extract and whole berry) and Cernitin on prostate growth in rats. Mol Cell Biochem. 2003;250:21
  32. Buck AC, Cox R, Rees RW, Ebeling L, John A. Treatment of outflow tract obstruction due to benign prostatic hyperplasia with the pollen extract, cernilton (A double-blind, placebo-controlled study). Br J Urol. 1990;66:398
  33. Lowe FC, Ku JC. Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urology. 1996;48:12
  34. Wilt TJ, Ishani A, MacDonald R, Stark G, Mulrow C, Lau J. Beta-sitosterols for benign prostatic hyperplasia. Cochrane Database Syst Rev. 1999;CD001043
  35. Debruyne F, Koch G, Boyle P, Da Silva FC, Gillenwater JG, Hamdy FC, et al. Comparison of a phytotherapeutic agent (permixon) with an alpha-blocker (tamsulosin) in the treatment of benign prostatic hyperplasia: a 1-year randomized international study. Eur Urol. 2002;41:497
  36. Barry MJ, Williford WO, Chang Y, Machi M, Jones KM, Walker-Corkery E, et al. Benign prostatic hyperplasia specific health status measures in clinical research: how much change in the American Urological Association symptom index and the benign prostatic hyperplasia impact index is perceptible to patients?. J Urol. 1995;154:1770

 Editor's Note: This article is the first of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 2492 and 2493.

PII: S0022-5347(08)00241-3

doi: 10.1016/j.juro.2008.01.094

The Journal of Urology
Volume 179, Issue 6 , Pages 2119-2125 , June 2008