Prostamol Uno - Fountain - Integrated Project
One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review Alternative Prostamol uno most important published data regarding this type of Alternative Prostamol uno for benign prostatic hyperplasia.
A review of the existing articles regarding the use of Serenoa repens extracts for benign prostatic hyperplasia was performed. The articles were analysed with regard to their relevance, scientific value and the size of the evaluated series. Alternative Prostamol uno efficacy, European Association of Urology guidelines state that Alternative Prostamol uno repens extracts significantly reduce nocturia Alternative Prostamol uno comparison with placebo.
However, the guideline committee is unable to make specific recommendations about phytotherapy of male lower urinary tract symptoms owing to the heterogeneity of the products and the methodological problems associated with meta-analyses.
Most of the published trials regarding Serenoa repens phytotherapy demonstrate a significant improvement of urinary status and a favourable safety profile.
Also, some authors have credited it with giving a significant improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding. The results of phytotherapy with Serenoa repens extracts are very promising. More high-quality, randomized, placebo-controlled Alternative Prostamol uno are required in order to demonstrate without doubt the true therapeutic value of these products.
Particular attention must be focused on differentiating between registered preparations, which are regulated as drugs, Alternative Prostamol uno those Alternative Prostamol uno to be food supplements.
Although the real incidence of benign prostatic hyperplasia BPH is difficult to assess, this pathological entity is widespread in the Alternative Prostamol uno male population [ Oelke et Alternative Prostamol uno.
Nowadays, medical therapy tends to replace the surgical approach in a significant number of cases. The most frequently prescribed and studied agent is the Serenoa repens extract, derived from the berry of the dwarf palm tree. However, many studies are limited by short-term follow up, a low number of patients, the absence of a placebo arm, or lack of standardized instruments to evaluate efficacy [ Giannakopoulos et al.
Controversies still remain regarding its mechanisms of action and its real therapeutic value. Nowadays, more than products containing Serenoa repens extract are available on Alternative Prostamol uno market worldwide, some registered as drugs and others as food supplements. The first use of the extract is attributed to the Native Americans, for genitourinary disturbances [ Murray and Pizzorno, ].
In the s, the berries started to be investigated for their medicinal properties. Multiple effects were reported, both digestive stimulating appetite and providing nutrition and reproductive increasing the Alternative Prostamol uno and secreting ability of the mammary glands, decreasing ovarian and uterine irritability, relieving dysmenorrhoea, ameliorating ovarian dysfunction, decreasing prostate enlargement etc. In the era of synthetic pharmaceuticals, Serenoa repenslike many other phytotherapeutic alternatives, was initially disregarded, only to be rediscovered when the mirage of the perfect BPH drug faded [ Buck, ].
The fruits of Serenoa repens are dark purple to black berries that grow in clusters and ripen from October to December. The source of the extract is the ripe, partially dried berries. Various extraction methods are used by different manufacturers, and for this reason it is probable that one product is not equivalent to another. The lipidosterolic extract of Serenoa repens Permixon was the first to be more rigorously evaluated, and in recent years new studies have emerged regarding the ethanolic extract Prostamol Uno [ Sinescu et al.
A steam hydrodistillate of Serenoa repens has also Alternative Prostamol uno reported. Chemical analysis of the resulting product identified steam-volatile components, including Alternative Prostamol uno structures that Alternative Prostamol uno not so far been described as constituents of these fruits [ Rösler et al.
However, no clear Alternative Prostamol uno are available regarding the advantages of one method of extraction or another.
A literature search reveals a significant number of studies addressing the subject of the mechanisms of action of Serenoa repens. Several have been proposed, including antiandrogenic action, an anti-inflammatory effect and an antiproliferative proapoptotic effect mediated through the inhibition of growth factors. However, the precise mechanisms of action are still to be described. However, variability of this effect was shown when evaluating various extracts on the market.
Phytotherapy also seems to be able to Alternative Prostamol uno the prolactin signal transduction pathways, as well as to block the effect of prolactin on protein kinase C-dependent phosphorylation of a potassium channel [ Van Coppenolle et al. These multiple synergistic mechanisms of action are explained by the fact that plant extracts are composites of several different molecules.
Moreover, not all the studies agree about the effects of the Serenoa repens extract. However, many physicians remain sceptical regarding its true therapeutic value. Phytotherapy was recently added to the European Association of Urology guidelines.
Clear data that Serenoa Alternative Prostamol uno extracts significantly reduce nocturia by comparison with placebo are cited. However, the guideline committee states that it is still unable to Alternative Prostamol uno specific recommendations about phytotherapy for male LUTS owing to the heterogeneity of the products and the methodological problems associated with meta-analyses [ Oelke et al.
Under these circumstances, a number of more strictly conducted trials have been performed in recent years. Many of the existing papers cover only a short-term follow up of 1—6 months [ Willetts et al. More recently, a few studies included a long-term follow up [ Alternative Prostamol uno et al. Most of the short- medium- and long-term studies showed statistically significant improvement in total international prostate symptom score IPSS during 6, 12 or 24 months of follow up [ Debruyne et al. When the irritative and obstructive IPSS subscores were separately evaluated, a decrease in both was seen [ Sinescu et al.
Regarding the quality-of-life score, although some studies reported only a limited improvement at 6 months [ Gerber et al. It is not completely Alternative Prostamol uno whether the study period is the only parameter explaining this difference, or there are some other issues involved.
Alternative Prostamol uno improvement in symptoms seems to be consistent throughout the existing studies, the effects on relevant urodynamic parameters tend to vary more widely.
Some of the papers describe insignificant improvements of the maximum urinary flow [ Debruyne et al. A combination of the two drugs showed no additional benefits Alternative Prostamol uno Hizli and Uygur, ]. The main issue regarding phytotherapy with Serenoa repens extract is that many of the existing placebo-controlled studies are not consistent in showing a significant superiority over placebo [ Bent et al.
The problem was recently raised in a meta-analysis, although the evaluation included studies of various durations as well as some on mixed herbal drugs consisting not only of Serenoa repens extract [ Tacklind et al.
Nowadays, some studies with high scientific value are producing more and more valuable data. This trial had no placebo arm, owing to concerns that the long-term lack of treatment in some patients would be unethical [ Sinescu et al. Some studies have described a significant improvement in the International Index of Erectile Function score following treatment with Serenoa repens extracts. The preoperative use of Serenoa repens extracts Alternative Prostamol uno been advocated for its ability to increase the efficacy of Alternative Prostamol uno resection of the prostate TURP and to decrease the surgically related complications, in particular, bleeding [ Pecoraro et al.
This aspect has been confirmed by other trials. The duration of surgery, overall intraoperative complications, transfusion needs, catheterization time and changes in haemodynamic parameters were significantly more favourable in the preoperatively treated study group [ Anceschi et al. This idea is, however, contested by some authors, who did not find any reduction of intraoperative bleeding after treatment with either Serenoa repens extract or dutasteride [ Tuncel et al.
However, there are more published articles that support the fact that phytotherapy has a role in decreasing TURP-related morbidity than those disputing it. Owing to the long-term nature of the therapy, safety aspects of the drug are of extreme importance. Most of the studies including those that were long term describe the satisfactory safety profile of Serenoa repens extracts [ Agbabiaka et al.
A systematic review of the literature, including 26 randomized controlled trials, four nonrandomized controlled trials, six uncontrolled trials and four case reports suggested that adverse events associated with the use of Serenoa repens are mild and similar to those seen in the placebo series of patients.
The most frequently reported adverse events are abdominal pain, diarrhoea, nausea, fatigue, headache, decreased libido, and rhinitis. More serious adverse events, such as death and cerebral haemorrhage, are extremely rarely reported.
Moreover, in these patients even the causality between the adverse event and the treatment is questionable. Furthermore, no drug interactions were reported [ Agbabiaka et al. Analysis of the existing clinical database indicates that extracts of Serenoa repens may Alternative Prostamol uno considered a viable first-line therapy for treating LUTS.
They offer significant improvements of urinary status while having a favourable safety profile. However, the existing herbal formulations are extremely heterogeneous and thus difficult to assess in meta-analysis. More randomized, placebo-controlled, long-term trials are needed in order to eliminate all scepticism Alternative Prostamol uno to the use of phytotherapeutic agents in BPH-related LUTS patients. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
The authors declare no conflicts of interest in preparing this article. National Center for Biotechnology InformationU.
Journal List Ther Adv Urol v. Ther Adv Urol. Author information Copyright and License information Disclaimer. Email: moc. This article has been cited by other articles in PMC. Keywords: benign Alternative Prostamol uno hyperplasia, lower urinary tract symptoms, phytotherapy, Serenoa repens. Introduction Although the real incidence of benign prostatic hyperplasia BPH is difficult to assess, this pathological entity is widespread in the elderly male population [ Oelke et al.
Extraction technique The fruits of Serenoa repens are dark purple to black berries that grow in clusters and ripen from October to December. Mechanisms of action A literature search reveals a significant number Alternative Prostamol uno studies addressing the Alternative Prostamol uno of the mechanisms of action of Serenoa repens.
Erectile function Some studies have described a significant improvement in the International Index of Erectile Function score following treatment with Serenoa Alternative Prostamol uno extracts. Impact on the outcome of surgical treatment The preoperative use of Serenoa repens extracts has been advocated for its ability to increase Alternative Prostamol uno efficacy of transurethral resection of the prostate TURP and to decrease the surgically related complications, in particular, bleeding [ Alternative Prostamol uno et al.
Safety issues Owing to the long-term nature of the Alternative Prostamol uno, safety aspects of the drug are of Alternative Prostamol uno importance. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Conflict of interest statement The authors declare no conflicts of interest in preparing this article. References Agbabiaka T. Results of a placebo-controlled double-blind study.