Role of Phytotherapy in the Management of BPH: A Summary of the Literature.

2023-02-28
Journal of clinical medicine 12(5)
- Vaki Antoniou
- Vineet Gauhar
- Sachin Modi
- Bhaskar Kumar Somani

PubMed: 36902686
DOI: 10.3390/jcm12051899

Study Design

Type: Review

Benign prostatic hyperplasia (BPH) describes the non-malignant enlargement of the prostate. It is both common and growing in incidence. Treatment is multimodal, involving conservative, medical, and surgical interventions. This review aims to examine the evidence base for phytotherapies, specifically analyzing their role in treating lower urinary tract symptoms (LUTS) attributable to BPH. A literature search was completed, specifically looking for randomized control trials (RCTs) and systematic reviews involving phytotherapy treating BPH. Specific emphasis was placed on exploring substance origin, the proposed mechanism of action, evidence of efficacy, and the side-effect profile. Several phytotherapeutic agents were evaluated. These included serenoa repens, cucurbita pepo, and pygeum Africanum, among others. For most of the reviewed substances, only modest effectiveness was reported. Generally, though, all treatments were tolerated well with minimal side effects. None of the treatments discussed in this paper form part of the recommended treatment algorithm in either European or American guidelines. We, therefore, conclude that phytotherapies, in the treatment of LUTS attributable to BPH, do provide a convenient option for patients, with minimal side effects. At present, however, the evidence for the usage of phytotherapy in BPH is inconclusive, with some agents having more backing than others. This remains an expansive field of urology whereby there is still more research to be done.

Research Insights

Pygeum Bark→Improved Lower Urinary Tract Symptoms
For most of the reviewed substances, only modest effectiveness was reported.
Effect
Neutral
Effect size
Small
Dose
not stated
Saw Palmetto→Improved Lower Urinary Tract Symptoms
For most of the reviewed substances, only modest effectiveness was reported.
Effect
Neutral
Effect size
Small
Dose
not stated
Zucchini→Improved Lower Urinary Tract Symptoms
For most of the reviewed substances, only modest effectiveness was reported.
Effect
Neutral
Effect size
Small
Dose
not stated

Adverse Events Reported

Zucchini→Overall tolerability
Generally, though, all treatments were tolerated well with minimal side effects.
Finding
Reported
Pygeum Bark→Overall tolerability
Generally, though, all treatments were tolerated well with minimal side effects.
Finding
Reported
Saw Palmetto→Overall tolerability
Generally, though, all treatments were tolerated well with minimal side effects.
Finding
Reported