Complementary and Alternative Medicine in Urology

An increasing use of complementary and alternative medicine (CAM) is apparent both in Asian and in Western countries for the management of numerous diseases to improve symptoms and to improve general health and well being. Many patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS), erectile dysfunction (ED), urinary tract infection (UTI) are using CAM. Complementary and alternative medicines for urologic malignancies such as renal cell carcinoma, bladder cancer, and prostate cancer are also one of the important issues in the management of patients. Dietary supplements and nutraceuticals are commonly used modality for the patients with BPH/LUTS or ED. Vegetables and cruciferous fruits showed significant preventive effect on urologic malignancies in many studies. Phytotherapy for BPH including beta-sitosterols, saw palmetto, pygeum, and nettles etc, is under vigorous research for their therapeutic effect. No solid evidence showing better effective treatment modality for ED than placebo was found yet in CAM area. Recently, a potent NO donor, L-arginine is under research with promising results. Cranberry juice has been used for the patients with recurrent UTI but safety was a limit for its use. Various antioxidants have been studied for prevention of urological malignancies. Lycopene, isoflavone, vitamin A, C, and E, and polyphenols showed the possibility of decreasing cancer incidence in many studies but their effect is still controversial. Vitamin D is known to be associated with cancer progression and the effect of combination treatment with other chemotherapeutic agents for advanced cancer is under trial. CAM is used by a number of patients with urological diseases and urologists need to have both accurate knowledge and apprehension of CAM. The possible effects and side effects should be defined and offered to the urologic patients by urologists. (Korean J Urol 2008;49:193-202) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏