Paula Viñas
José de Felippe Junior

Geral

Herbs for benign prostatic hyperplasia.
Ann Pharmacother;36(9):1443-52, 2002 Sep. Dvorkin L; Song KY

Resumo: OBJECTIVE: To review and evaluate the literature relative to the use of herbal therapies in the treatment of benign prostatic hyperplasia. DATA SOURCES: Literature was identified by MEDLINE, Embase, International Pharmaceutical Abstracts, and the International Bibliographic Information on Dietary Supplements searches and through cross-referencing of selected articles. STUDY SELECTION/DATA EXTRACTION: All articles identified from the data sources were evaluated and all information deemed relevant was included in this review. DATA SYNTHESIS: A large percentage of men >50 years old begin to experience signs and symptoms of benign prostatic hyperplasia (BPH). Herbs hold promise in the treatment of BPH. Serenoa repens, Pygeum africanum, Urtica dioica radix, and Cucurbita peponis semen are some of the botanical therapies used in the treatment of BPH. CONCLUSIONS: There are many European studies examining efficacy, dose, and adverse effects of these plants in the treatment of BPH. However, numerous questions remain. These include issues concerning long-term beneficial and adverse effects of herbal therapy, prevention of complications, standardization of extracts, and concomitant use with [quot ]mainstream[quot ] medications. Based on the information available today, these botanical therapies can be used for treatment of a number of objective and subjective symptoms in patients with BPH, stages I and II.

Herbal medications in the treatment of benign prostatic hyperplasia (BPH).
Urol Clin North Am;29(1):23-9, vii, 2002 Feb. Fagelman E; Lowe FC

Resumo: Herbal medications are used widely in the treatment of BPH. Recent studies suggest a benefit for some of these products with few side effects. The results of these studies are summarized and the possible mechanism of action of these medications are reviewed.

The role of phytotherapy in treating lower urinary tract symptoms and benign prostatic hyperplasia.
World J Urol;19(6):426-35, 2002 Apr. Dreikorn K

País de publicação: Germany

Resumo: Despite their traditional popularity in many European countries and their increasing use as dietary supplements in the United States, the role of phytotherapeutic agents in treating lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) is continuously debated. If strict criteria of evidence-based medicine are applied, the available data have not yet provided clear evidence of efficacy for most phytotherapeutic preparations. Different extraction procedures used by the different manufacturers, the variations of the raw products (plants) used and the fact that the potentially active component(s) of the final product and its (their) mechanism(s) of action are still under investigation make comparisons between the various products impossible. Thus, one product might have clinical efficacy while another might not. Therefore, as long as the composition of the final product of the various preparations is not proven to be identical, each manufacturer's preparation must be evaluated separately, using the gold standard of placebo-controlled studies according to accepted guidelines. Conclusions of meta-analyses that include products from different plants undergoing different extraction procedures and that are used in different dosages may be misleading. A number of short-term randomised trials and some metaanalyses in the recent literature suggest clinical efficacy and good tolerability for some preparations, mainly extracts from Serenoa repens and also Pygeum africanum, products with high concentrations of beta-sitosterol, and pumpkin seeds. It is also claimed that the efficacy of an extract from S. repens is comparable to that of finasteride and alpha-blockers. However, as has been demanded by the International Consultations on BPH, additional randomised, placebo-controlled trials are needed before phytotherapeutic agents can be recommended as an effective option in treating LUTS and BPH.

Phytotherapy for benign prostatic hyperplasia.
Public Health Nutr;3(4A):459-72, 2000 Dec. Wilt TJ; Ishani A; Rutks I; MacDonald R

Resumo: OBJECTIVE: To systematically review the existing evidence regarding the efficacy and safety of phytotherapeutic compounds used to treat men with symptomatic benign prostatic hyperplasia (BPH). DESIGN: Randomized trials were identified searching MEDLINE (1966--1997), EMBASE, Phytodok, the Cochrane Library, bibliographies of identified trials and review articles, and contact with relevant authors and drug companies. The studies were included if men had symptomatic benign prostatic hyperplasia, the intervention was a phytotherapeutic preparation alone or combined, a control group received placebo or other pharmacologic therapies for BPH, and the treatment duration was at least 30 days. Key data were extracted independently by two investigators. RESULTS: A total of 44 studies of six phytotherapeutic agents (Serenoa repens, Hypoxis rooperi, Secale cereale, Pygeum africanum, Urtica dioica, Curcubita pepo) met inclusion criteria and were reviewed. Many studies did not report results in a method allowing meta-analysis. Serenoa repens, extracted from the saw palmetto, is the most widely used phytotherapeutic agent for BPH. A total of 18 trials involving 2939 men were reviewed. Compared with men receiving placebo, men taking Serenoa repens reported greater improvement of urinary tract symptoms and flow measures. Serenoa repens decreased nocturia (weighted mean difference (WMD) = -0.76 times per evening; 95% CI = -1.22 to -0.32; n = 10 studies) and improved peak urine flow (WMD = 1.93 ml s(-1); 95% CI = 0.72 to 3.14, n = 8 studies). Men treated with Serenoa repens rated greater improvement of their urinary tract symptoms versus men taking placebo (risk ratio of improvement = 1.72; 95% CI = 1.21 to 2.44, n = 8 studies). Improvement in symptoms of BPH was comparable to men receiving the finasteride. Hypoxis rooperi (n = 4 studies, 519 men) was also demonstrated to be effective in improving symptom scores and flow measures compared with placebo. For the two studies reporting the International Prostate Symptom Score, the WMD was -4.9 IPSS points (95% CI = -6.3 to -3.5, n = 2 studies) and the WMD for peak urine flow was 3.91 ml s(-1) (95% CI = 0.91 to 6.90, n = 4 studies). Secale cereale (n = 4 studies, 444 men) was found to modestly improve overall urological symptoms. Pygeum africanum (n = 17 studies, 900 men) may be a useful treatment option for BPH. However, review of the literature has found inadequate reporting of outcomes which currently limit the ability to estimate its safety and efficacy. The studies involving Urtica dioica and Curcubita pepo are limited although these agents may be effective combined with other plant extracts such as Serenoa and Pygeum. Adverse events due to phytotherapies were reported to be generally mild and infrequent. CONCLUSIONS: Randomized studies of Serenoa repens, alone or in combination with other plant extracts, have provided the strongest evidence for efficacy and tolerability in treatment of BPH in comparison with other phytotherapies. Serenoa repens appears to be a useful option for improving lower urinary tract symptoms and flow measures. Hypoxis rooperi and Secale cereale also appear to improve BPH symptoms although the evidence is less strong for these products. Pygeum africanum has been studied extensively but inadequate reporting of outcomes limits the ability to conclusively recommend it. There is no convincing evidence supporting the use of Urtica dioica or Curcubita pepo alone for treatment of BPH. Overall, phytotherapies are less costly, well tolerated and adverse events are generally mild and infrequent. Future randomized controlled trials using standardized preparations of phytotherapeutic agents with longer study durations are needed to determine their long-term effectiveness in the treatment of BPH.

Review of recent placebo-controlled trials utilizing phytotherapeutic agents for treatment of BPH.
Prostate;37(3):187-93, 1998 Nov 1. Lowe FC; Dreikorn K; Borkowski A; Braeckman J; Denis L; Ferrari P; Gerber G; Levin R; Perrin P; Senge T

Resumo: BACKGROUND: In order to assess the efficacy of phytotherapeutic agents for the treatment of benign prostatic hyperplasia (BPH), a review of recently published double-blind placebo-controlled trials was undertaken. METHODS: Only those studies reviewed by the Other Medical Therapies Committee of the Fourth International Consultation on BPH were included. RESULTS: These studies suggest a possible benefit for the use of phytotherapeutic preparations in the treatment of BPH. CONCLUSIONS: These studies need to be confirmed in larger long-term placebo-controlled studies in order to ascertain the true efficacy of these agents.

Phytotherapy of benign prostatic hyperplasia
Urologe A;36(1):10-7, 1997 Jan. Bracher F

País de publicação: GERMANY

Resumo: Phytopharmaceutical agents have been used for a long time in the treatment of symptomatic benign prostatic hyperplasia (BPH). However, until recently, it has been questioned whether phytotherapy is superior to a placebo treatment. In this article, the most widely used phytopharmaceutical agents, such as saw palmetto berry extracts, Radix urticae extracts, pumpkin seeds, pollen extracts and different phytosterols, are described. In addition, both in vitro and in vivo studies are discussed in an attempt to explain a possible mechanism of action. There are several new clinical studies which demonstrate a significant benefit compared with placebo treatment. Based on these results, the use of phytopharmaceutical agents for the treatment of mild to moderate symptomatic BPH seems to be well justified. So far, no significant inhibition of further prostate growth has been demonstrated. For this, a careful follow-up of the patients is necessary so as not to miss a deterioration and perhaps the need for an operation.

Status of phytotherapeutic drugs in treatment of benign prostatic hyperplasia
Urologe A;34(2):119-29, 1995 Mar. Dreikorn K; Schönhöfer PS

País de publicação: GERMANY

Resumo: Phytotherapeutic preparations are still commonly used for the treatment of symptomatic benign prostate hyperplasia (BPH) in Germany; in recent years there has even been an increase in their use, so that sales now amount to more than DM 220 millions per year. The preparations most frequently used are extracts of Hypoxis rooperi, the roots of the stinging nettle, the fruits of the saw palmetto, pumpkin seeds and rye pollen. The suggested mechanisms of action have not been documented by scientific observation. This applies especially to the blocking effect on 5 alpha-reductase postulated with the doses used. Moreover, a critical analysis of the data available suggests that the effects of phytotherapy are no better than those of placebo treatment. Further studies are urgently needed, to compare the effects of phytotherapy with those of chemically defined drugs (alpha 1-receptor antagonists, 5 alpha-reductase blocker) that seem to have a beneficial influence on the pathomechanism underlying symptomatic BPH.

Mistura de plantas

Comparative evaluation of Prostina and terazosin in the treatment of benign prostatic hyperplasia.
J Indian Med Assoc;103(2):108-10, 112, 2005 Feb. Dogra PN; Biswas NR; Ravi AK; Mani K; Kumar V

País de publicação: India

Resumo: The objective of the present study was to evaluate the efficacy and safety of Prostina, a multi-ingredient herbal formulation in benign prostatic hyperplasia (BPH) in comparison with terazosin. A randomised, open, parallel, controlled clinical trial was carried out in ambulatory men aged between 40-80 years suffering from BPH, with American Urological Association (AUA) symptom index score of at least 8 or more at recruitment. One group received 2 Prostina capsules twice daily for 12 weeks; the other received terazosin 2 mg at bedtime for 12 weeks. Urodynamic parameters, AUA score, biochemical and clinical adverse effects were assessed. Twenty subjects completed the study in Prostina group and 20 in terazosin group. The groups were comparable at baseline in age and assessment criteria. Majority of urodynamic parameters showed improving trends in both the groups. AUA symptom score declined significantly from 19.50 +/- 1.40 (mean +/- standard error) to 1.04 +/- 0.68 in Prostina group and from 16.95 +/- 1.23 to 4.14 +/- 0.88 in terazosin group. The AUA symptom score in 12 weeks follow-up was significantly lower in Prostina group than terazosin group (p = 0.005). Other laboratory-parameters remained unaltered in both the groups. Prostina is as effective as terazosin in providing symptomatic relief in BPH.

Plantas chinesas

Conservative treatment of benign prostatic hypertrophy--clinical effects of increased administration of Hachimijiogan and the relation between these effects and the [quot ]Sho[quot ] of Chinese medicine
Hinyokika Kiyo;31(3):545-51, 1985 Mar. Yachiku S; Kaneko S; Matsuura T; Akiyama T; Kurita T País de País de publicação: JAPAN

Resumo: Tsumura Hachimijiogan, 7.5 g a day, was administered to 30 patients with benign prostatic hypertrophy (BPH). Clinical effects were estimated based on subjective symptoms and objective findings obtained by uroflowmetry. Twenty patients (66.7%) showed improvement of subjective symptoms and 14 patients (46.7%) showed good response in uroflowmetry. An improvement of overall clinical efficacy was observed in 21 patients (70%). These results were better than those obtained with 5.0 g a day doses of Tsumura Hachimijiogan. No significant relation between the [quot ]Sho[quot ] in Chinese medicine and the clinical effects of Hachimijiogan was detected. No side effects or abnormal laboratory data were found in any of these 30 patients.

Abobora

Treatment of benign prostatic hyperplasia with phytosterols.
Br J Urol. 1990 Dec;66(6):639-41.
Carbin BE, Larsson B, Lindahl O.
Department of Urology, Karolinska Hospital, Stockholm, Sweden.

In a randomised, double-blind study, the preparation Curbicin, obtained from pumpkin seeds and dwarf palm plants (Cucurbita pepo L. and Sabal serrulata), was compared with a placebo in the treatment of symptoms caused by prostatic hyperplasia; 53 patients took part in the study, which was carried out over a 3-month period. Urinary flow, micturition time, residual urine, frequency of micturition and a subjective assessment of the effect of treatment were all significantly improved in the treatment group. No untoward side effects were noted

Brassica alba

An experimental study(II) on the inhibition of prostatic hyperplasia by extract of seeds of Brassica alba
Zhongguo Zhong Yao Za Zhi;28(7):643-6, 2003 Jul. Wu GX; Lin YX; Ou MR; Tan DF

País de publicação: China

Resumo: OBJECTIVE: To study the active components and their functionary mechanism of the extract of Brassica alba seeds, which inhibits experimental mice prostatic hyperplasia. METHOD: Prostatic hyperplasia of castrated male mice induced by testosterone propionate, the penetrability of capillary vessel of mice skin induced by histamine and the endermic flesh bud of rat induced by filter paper were used as experimental models. Sinalbin and beta-sitosterol separated from seeds of Brassica alba were used to test the activities. RESULT: Sinalbin and beta-sitosterol(16.0 mg.kg-1.d-1 and 8.0 mg.kg-1.d-1) could significantly inhibit mice prostatic hyperplasia induced by testosterone propionate and activity of serum acid phosphatase(P < 0.01 or P < 0.05), Sinalbin(16.0 mg.kg-1.d-1)could significantly inhibit the hyperplasia of endermic flesh bud in rat induced by filter paper(P < 0.05), beta-sitosterol(16.0 mg.kg-1.d-1 and 8.0 mg.kg-1.d-1) could significantly decrease the penetrability of capillary vessel of mice skin induced by histamine. CONCLUSION: Sinalbin and beta-sitosterol have anti-androgen and anti-inflammation activiti

An experimental study(I) on the inhibition of prostatic hyperplasia with extract of seeds of Brassica alba
Zhongguo Zhong Yao Za Zhi;27(10):766-8, 2002 Oct. Wu GX; Lin YX; Ou MR; Tan DF

País de publicação: China

Resumo: OBJECTIVE: To study the effective fraction of the extract of seeds of Brassica alba, which inhibits experimental mice prostatic hyperplasia. METHOD: An experimental model of prostatic hyperplasia of castrated male mice induced by testosterone propionate was made. Fractions I, II and III were prepared by extracting the seeds of Brassica alba successively with ether, ethanol and water under reflux. Total extract was prepared by extracting the seeds of Brassica alba with 60% ethanol under reflux. The total extract and the three fractions were used to test the activities. RESULT: Total extract, fractions I and II could not only significantly inhibit mice prostatic hyperplasia induced by testosterone propionate and activity of serum acid phosphatase, but also decrease wet weight of preputial glands, while fraction III is inactive. CONCLUSION: Extract from seeds of Brassica alba can significantly inhibit mice prostatic hyperplasia induced by exterior hormone, possessing an activity of anti-androgen. Fractions I and II show an equivalent activity of total extract, which indicate that these fractions contain active components of seeds of Brassica alba which can inhibit prostatic hyperplasia.

Sabal serrulata ( dwarf palm )

Sabal serrulata extract in the management of symptoms of prostatic hypertrophy
Orv Hetil;138(7):419-21, 1997 Feb 16. Kondás J; Philipp V; Diószeghy G

País de publicação: HUNGARY

Resumo: The effectiveness of Sabal serrulata (dwarf palm) extract was evaluated in the treatment of 38 patients with symptomatic prostatic hyperplasia. During a 12-month treatment controlled by investigations the subjective symptoms decreased in nearly three fourth of the patients. Side effects were not observed. According to uroflowmetric investigations the average peak flow value increased from 10.36 ml/sec to 14.44 ml/sec (p < 0.0001) and the average mean flow value from 0.02 ml/sec to 7.45 ml/sec (p < 0.001). After treatment residual urine volume decreased or was nil in more than 9/10 of the cases. The average decrease of residue was 47 ml (p < 0.001). The average decrease in prostatic volume was 10.6% (p < 0.02). On the basis of their favorable experience the authors recommend the administration of Sabal serrulata extract in the treatment of patients with mild or moderate symptoms of prostatic hyperplasia.

Saw palmeto

Extracts from fruits of saw palmetto (Sabal serrulata) and roots of stinging nettle (Urtica dioica): viable alternatives in the medical treatment of benign prostatic hyperplasia and associated lower urinary tracts symptoms.
Planta Med;67(6):489-500, 2001 Aug. Koch E

País de publicação: Germany

Resumo: Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are very common disorders in aging men. Despite the great clinical importance, many aspects of their aetiology remain uncertain although it is generally accepted that advanced age and testicular androgens are important requirements for the development of these complaints. The currently available therapeutic options include watchful waiting, changes of life style, medical treatments and invasive therapies. In many European countries the use of phytopharmaceuticals for the management of BPH and related LUTS is common and these products represent up to 80 % of all drugs prescribed for this disorder. In particularly, extracts from the fruits of saw palmetto (Sabal serrulata, syn. Serenoa repens) and the roots of stinging nettle (Urtica dioica) are popular. During the last years numerous papers have been published which elaborated on the pharmacological activities and the clinical assessment of these herbal remedies. These investigations have not only broadened the scientific basis for the rational use of phytotherapeutics but have also provided evidence for their therapeutic efficacy and favourable safety profile.

Serenoa repens

Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial .
BJU Int;92(3):267-70, 2003 Aug. Willetts KE; Clements MS; Champion S; Ehsman S; Eden JA

Resumo: OBJECTIVE: To compare the effect of a Serenoa repens extract with placebo for symptoms of benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: In a double-blind placebo-controlled randomized trial between January 1999 and March 2000, 100 men with symptoms of BPH, aged < 80 years, with a maximum urinary flow rate of 5-15 mL/s for a voiding volume of 150 mL, were randomly and equally allocated to 320 mg S. repens extract or placebo (paraffin oil). The main outcome measures were the International Prostate Symptom Score (IPSS), peak urinary flow rate, and the Rosen International Index of Erectile Function (IIEF) questionnaire. RESULTS: There was no significant difference between the treatments over the 12 weeks of the study in the IPSS, peak urinary flow rate or for the IIEF questionnaire. CONCLUSIONS: During the trial all participants had some improvement in their symptoms of BPH but there was no significant beneficial effect of this S. repens extract over placebo in this 12-week trial.

Effects of an extract of Serenoa repens on dogs with hyperplasia of the prostate gland.
Am J Vet Res;61(8):880-5, 2000 Aug. Barsanti JA; Finco DR; Mahaffey MM; Fayrer-Hosken RA; Crowell WA; Thompson FN; Shotts EB

Resumo: OBJECTIVE: To determine effects of an extract of Serenoa repens on dogs with prostatic hyperplasia. ANIMALS: 20 mature male dogs with benign prostatic hyperplasia. PROCEDURE: Dogs were assigned to 3 comparable groups on the basis of prostatic volume per kg of body weight and degree of prostatic hyperplasia determined histologically. Dogs in 2 groups were treated for 91 days (8 received 500 mg, PO, q 8 h [1,500 mg/d], and 6 received 100 mg, PO, q 8 h [300 mg/d]). The control group of 6 dogs did not receive medication. Effects of treatment on prostatic volume, prostatic weight, prostatic histologic characteristics, radiographic and ultrasonographic assessment of prostatic size, results of CBC, serum biochemical analyses, and urinalysis, serum testosterone concentration, and semen characteristics were determined. At the termination of the study, all dogs were euthanatized, and necropsies were performed. Investigators conducting tests and interpreting results were not aware of treatment group of each dog. RESULTS: Treatment did not affect prostatic weight, prostatic volume, or prostatic histologic scores, libido, semen characteristics, radiographs of the caudal portion of the abdomen, prostatic ultrasonographs, or serum testosterone concentrations. Results of CBC, serum biochemical analyses or urinalysis, and body weights did not change during treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment with an extract of S repens for 91 days did not significantly affect the prostate gland of dogs. Adverse effects were not evident. Although products containing extracts of S repens are widely advertised for men with prostatic hyperplasia, beneficial or harmful effects of this plant extract were not found in dogs with prostatic hyperplasia.

Effect of Serenoa repens extract (Permixon) on estradiol/testosterone-induced experimental prostate enlargement in the rat.
Pharmacol Res;34(3-4):171-9, 1996 Sep-Oct. Paubert-Braquet M; Richardson FO; Servent-Saez N; Gordon WC; Monge MC; Bazan NG; Authie D; Braquet P

Resumo: The effect of the lipidosterolic extract of Serenoa repens (LSESR) on experimental prostate enlargement was investigated in three groups of rats: shams treated with LSESR (sham rats), castrated animals treated with estradiol and testosterone (castrated rats), castrated animals treated with estradiol/testosterone and treated with LSESR (castrated and treated rats). Following three months of continuous hormonal treatment, the weight of prostates in estradiol/testosterone-treated castrated rats was significantly increased in comparison with sham-operated rats. Such an increase started rapidly, reached a maximum by 30 days and remained at a plateau or slightly declined thereafter. The increase of prostate total weight induced by the hormone treatment was inhibited by administration of LSESR. Indeed, the weight was significantly lower at day 60 and day 90 for the dorsal and lateral regions of the prostate. The weight of the ventral region of the prostate was significantly lower after 30 and 60 days treatment with LSESR. These results demonstrate that administering LSESR to hormone-treated castrated rats inhibits the increase in prostate wet weight. This effect of LSESR may explain the beneficial effect of this extract in human benign prostatic hypertrophy.

Lack of effects of a lyposterolic extract of Serenoa repens on plasma levels of testosterone, follicle-stimulating hormone, and luteinizing hormone.
Clin Ther;10(5):585-8, 1988. Casarosa C; Cosci di Coscio M; Fratta M

Resumo: Twenty men, aged 50 to 75 years (mean, 67 years), suffering from benign prostatic hypertrophy received 160 mg of a lyposterolic extract of Serenoa repens, twice daily for 30 days. Before and at the end of treatment, plasma levels of testosterone, follicle-stimulating hormone, and luteinizing hormone were determined. No changes in plasma hormone levels occurred as a result of treatment. It is concluded that Serenoa extract, which is useful in the treatment of benign prostatic hypertrophy, does not act via systemic changes of hormone levels.

Urtica dioica

The inhibiting effects of Urtica dioica root extracts on experimentally induced prostatic hyperplasia in the mouse.
Planta Med;63(4):307-10, 1997 Aug. Lichius JJ; Muth C

País de publicação: GERMANY

Resumo: Extracts of stinging nettle roots (Urtica dioica L. Urticaceae) are used in the treatment of benign prostatic hyperplasia (BPH). We established a BPH-model by directly implanting an urogenital sinus (UGS) into the ventral prostate gland of an adult mouse. Five differently prepared stinging nettle root extracts were tested in this model. The 20% methanolic extract was the most effective with a 51.4% inhibition of induced growth.

Effects of stinging nettle root extracts and their steroidal components on the Na+,K(+)-ATPase of the benign prostatic hyperplasia.
Planta Med;60(1):30-3, 1994 Feb. Hirano T; Homma M; Oka K

País de publicação: GERMANY

Resumo: The effects of organic-solvent extracts of Urtica dioica (Urticaceae) on the Na+,K(+)-ATPase of the tissue of benign prostatic hyperplasia (BPH) were investigated. The membrane Na+,K(+)-ATPase fraction was prepared from a patient with BPH by a differential centrifugation of the tissue homogenate. The enzyme activity was inhibited by 10(-4)-10(-5) M of ouabain. The hexane extract, the ether extract, the ethyl acetate extract, and the butanol extract of the roots caused 27.6-81.5% inhibition of the enzyme activity at 0.1 mg/ml. In addition, a column extraction of stinging nettle roots using benzene as an eluent afforded efficient enzyme inhibiting activity. Steroidal components in stinging nettle roots, such as stigmast-4-en-3-one, stigmasterol, and campesterol inhibited the enzyme activity by 23.0-67.0% at concentrations ranging from 10(-3)-10(-6) M. These results suggest that some hydrophobic constituents such as steroids in the stinging nettle roots inhibited the membrane Na+,K(+)-ATPase activity of the prostate, which may subsequently suppress prostate-cell metabolism and growth.

Results of a double-blind study on the effectiveness of ERU (extractum radicis Urticae) capsules in conservative treatment of benign prostatic hyperplasia
Ergebnisse einer Doppelblindstudie über die Wirksamkeit von ERU-Kapseln in der konservativen Behandlung der benignen Prostatahyperplasie..

Urologe A;24(1):49-51, 1985 Jan. Vontobel HP; Herzog R; Rutishauser G; Kres H

País de publicação: GERMANY, WEST

Resumo: In 50 patients with prostatic hyperplasia the effect on symptomatology and objective findings of ERU-capsules versus placebo was investigated in a double-blind study over a 9 week treatment period. Admitted to the study were patients in phases I and II who had been referred to the clinic in order to evaluate up the indication for operation. Concerning subjective complaints there was an improvement in dysuric symptoms in both patient groups. The evaluation of the objective parameters showed significant differencies. There was a statistically highly significant (p = 0.0005) decrease of the sex hormone binding globulin in the group of patients treated with ERU as well as a significant improvement of the micturition volume and maximum urinary flow. The improvement of the average flow in the ERU group was not significant. The increase of residual urine volume in both groups seems not to be significant according to the Covariance-analysis and is difficult to interpret. It is assumed, that, up to a certain grade, for a selected group of patients, mainly in the phase of beginning decompensation, length and dosage of therapy were possibly not sufficiently adjusted.

An urodynamic study of patients with benign prostatic hypertrophy treated conservatively with phytotherapy or testosterone (author's transl)
Wien Klin Wochenschr;91(18):622-7, 1979 Sep 28. Flamm J; Kiesswetter H; Englisch M

País de publicação: AUSTRIA

Resumo: Conservative therapy of benign prostatic hypertrophy comprises the administration of oestrogens, gestagens, androgens and anti-androgens. Phytodrugs, which contain an extract of Sabal serrulatum or Pygeum Africana as active substance are without side effects and are, therefore, being used increasingly. 74 patients with irritable or obstructive bladder symptoms due to benign prostatic hypertrophy were treated with a phytodrug (Sabal serrulatum) or with testosterone throughout a period of three months. In group one (20 patients given phytodrugs and 10 patients given testosterone) clinical symptoms and measurements of residual urine, residual urine quotient, bladder capacity, micturition pressure and maximum urethral closure pressure were recorded at the beginning and at the end of therapy. In group two 28 patients were treated with the phytodrug in the first and third months with an intervening placebo trial lasting four weeks and 16 patients were given testosterone. Clinical symptoms and uroflow and residual urine only were charted in this group. None of the patients in either group showed an improvement in the urodynamic parameters of obstruction, but all patients felt a subjective alleviation of their symptoms.

Urtica ( câncer de próstata)

Antiproliferative effect of a polysaccharide fraction of a 20% methanolic extract of stinging nettle roots upon epithelial cells of the human prostate (LNCaP).
Pharmazie;54(10):768-71, 1999 Oct. Lichius JJ; Lenz C; Lindemann P; Müller HH; Aumüller G; Konrad L

País de publicação: GERMANY

Resumo: In Germany, plant extracts are often used in the treatment of early stages of benign prostate hyperplasia (BPH). The effects of different concentrations of the polysaccharide fraction of the 20% methanolic extract of stinging nettle roots (POLY-M) on the cellular proliferation of lymph node carcinoma of the prostate (LNCaP) cells were determined by measurement of the genomic DNA content of the samples. All concentrations of POLY-M showed an inhibitory effect on the growth of the LNCaP cells during 7 days except the two lowest concentrations. The reduced proliferation of POLY-M treated LNCaP cells was significantly (p < 0.05) different from the untreated control. The inhibition was time- and concentration-dependent with the maximum suppression (50%) on day 6 and at concentrations of 1.0E-9 and 1.0E-11 mg/ml. No cytotoxic effect of POLY-M on cell proliferation was observed. The in vitro results show for the first time an antiproliferative effect of Urtica compounds on human prostatic epithelium and confirm our previous in vivo findings.

Lower urinary tract symptoms/benign prostatic hyperplasia: minimizing morbidity caused by treatment.
Urology;62(3 Suppl 1):24-33, 2003 Sep. Schulman CC

Resumo: The beneficial effects of treatment for lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), or LUTS/BPH, have to be balanced against the morbidity associated with treatment. Invasive surgery, such as transurethral resection of the prostate, has been associated with irreversible complications (eg, impotence and retrograde ejaculation). Alpha(1)-adrenoceptor antagonists provide effective and fast relief of LUTS/BPH. In contrast to finasteride, they are not associated with sexual dysfunction (eg, decreased libido or impotence). Alpha(1)-adrenoceptor antagonists induce adverse events associated with interference with blood pressure regulation. The alpha(1A)/alpha(1D)-adrenoceptor antagonist tamsulosin has the lowest potential to interfere with blood pressure regulation and induce related adverse events. In addition, tamsulosin seems to be as well tolerated as phytotherapy, except for a higher incidence of abnormal ejaculation. Abnormal ejaculation occurs in 4% to 11% of patients receiving a alpha(1)-adrenoceptor antagonist, which is, however, well tolerated; <1% of patients discontinue because of this adverse event. In placebo-controlled trials, abnormal ejaculation has been predominantly reported for tamsulosin, but in most direct comparative studies, the incidence was comparable to that of other alpha(1)-adrenoceptor antagonists. Men with LUTS/BPH have an increased risk of impaired sexual function. However, alpha(1)-adrenoceptor antagonists, such as tamsulosin, may slightly improve sexual dysfunction together with LUTS problems. Combination therapy of an alpha(1)-adrenoceptor antagonist and finasteride has a similar adverse-event profile as each monotherapy, except for an increased risk of abnormal ejaculation. The discontinuation rate because of adverse events does not seem to be higher than with monotherapy. Medical therapies, and particularly alpha(1)-adrenoceptor antagonists such as tamsulosin, can be considered a first-line treatment option for LUTS/BPH because they provide effective relief of bothersome LUTS with excellent tolerability.