Serenoa repensfor benign prostatic hyperplasia

Abstract

Background-Benign prostatic hyperplasia (BPH), a nonmalignant enlargement of the prostate, 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 (also known by its botanical name of Sabal serrulatum), is one of several phytotherapeutic agents available for the treatment of BPH.Objectives-This systematic review aimed to assess the effects of Serenoa repens in the treatment of LUTS consistent with BPH.Search strategy-Trials were searched in computerized general and specialized databases (MEDLINE, EMBASE, and The Cochrane Library), by checking bibliographies, and by handsearching the relevant literature.Selection criteria-Trials were eligible if they (1) randomized men with symptomatic BPH to receive preparations of Serenoa repens (alone or in combination) for at least four weeks in comparison with placebo or other interventions, and (2) included clinical outcomes such as urologic symptom scales, symptoms, and urodynamic measurements. Eligibility was assessed by at least two independent observers. Data collection and analysis-Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. The main outcome measure for comparing the effectiveness of Serenoa repens with placebo or other interventions was the change in urologic symptom-scale scores. Secondary outcomes included changes in nocturia and urodynamic measures. The main outcome measure for side effects or adverse events was the number of men reporting side effects.Main results-In this update 9 new trials involving 2053 additional men (a 64.8% increase) have been included. For the main comparison -Serenoa repens versus placebo -3 trials were added with 419 subjects and 3 endpoints (IPSS, peak urine flow, prostate size). Overall, 5222 subjects from 30 randomized trials lasting from 4 to 60 weeks were assessed. Twenty-six trials were double blinded and treatment allocation concealment was adequate in eighteen studies.

Comparison of Tamsulosin Plus Serenoa Repens with Tamsulosin in the Treatment of Benign Prostatic Hyperplasia in Korean Men: 1-Year Randomized Open Label Study

“…There are several systematic reviews about serenoa repens to compare with placebo for benign prostatic hyperplasia [12,13]. These could not find any difference in the treatment of BPH with serenoa repens to placebo.…”

<b><i>Serenoa repens</i></b> bei benigner Prostatahyperplasie

“…Diese erschienen 2000, 2002, 2009 und 2012 [1,2,3,4]. Die beiden ersten Reviews führten zu einem positiven Resultat: …”

“…Der Review von 2009 kam dann allerdings zu einem ganz anderen Schluss: « Serenoa repens was not more effective than placebo for treatment of urinary symptoms consistent with BPH» [3]. …”

Cochrane Reviews und pflanzliche Arzneimittel: Zum Teil positive Resultate

“…2009 erschien ein Review über die Wirksamkeit von Serenoa repens (Sägepalme) bei benigner Prostata-hyperplasie (BPH) [1] und hat der Arzneinpflanze die Wirksamkeit abgesprochen. Die Übersichtsarbeit überprüfte Studien, die Präparate aus S.repens ohne nähere Angaben und Qualitätsstandard verwendeten, und sogar einige Studien, bei denen das Prüfpräparat neben S.repens noch weitere Inhaltsstoffe enthielt.…”