Review: Pygeum africanum extracts improve symptoms and urodynamics in symptomatic benign prostatic hyperplasia.

M a i n r e s u l t s 18 RCTs (1562 patients) met the selection criteria. Comparisons included P. africanum extract with placebo (13 RCTs), P. africanum extract with an anti-inflammatory drug (2 RCTs), P. africanum extract with another herbal agent (1 RCT), different daily doses of P. africanum extract (1 RCT), and 2 different doses of P. africanum extract in combination with another herbal extract (1 RCT). Improvement in the combined outcome of urologic symptoms and flow measurements was greater in the P. africanum group than in the placebo group (effect size −0.8 standard deviation [SD], 95% CI −1.4 to −0.3, a moderate to large effect) (6 RCTs). Although not statistically significant, reduction in nocturia was 19% greater in the P. africanum group than in the placebo group (effect size −0.8 SD, CI −1.4 to −0.1, 3 RCTs) (Table). More men in the P. africanum group than in the placebo group had an overall improvement in symptoms rated by their physician (5 RCTs) (Table). Increase in peak urine flow was 23% greater in the P. africanum group than in the placebo group (4 RCTs) (Table). Reduction in residual urine volume was 24% greater in the P. africanum group than in the placebo group (2 RCTs) (Table). The groups did not differ for dropout rates and adverse effects.