Health Condition: Men’s Health

OBJECTIVE: Men affected with Benign Prostate Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS) are demonstrating to require an increasing amount of attention from Urologists and Primary‐care Physicians. Over the years, common urological medications were based on either alpha‐blockers and/or 5alpha‐reductase inhibitors. During the last decade the phytotherapeutic drugs are gaining a more often central role in the BPH and LUTS managements. In particular, clinical usage of the extract of the dried ripe fruit of serenoa repens with a dosage of 320 mg per day, has shown its clinical efficacy and its superiority. Purpose of this multicentric observational retrospective study was to evaluate all the urological aspects (clinical, biochemical, instrumental and pathological) of patients affected by BPH and LUTS, with a PSA < 10 ng/ml, a previous negative prostatic biopsy and in therapy with a daily dose of 320/640 mg of serenoa repens. PATIENTS AND METHODS: The study was conducted in 8 different centers throughout Italy from September 2010 to November 2011. Data and information of 298 men with an average of 63 years (mean PSA of 5.4 ng/ml and mean prostate gland volume of 57 cc), affected by non‐acute urinary symptoms caused by BPH, a dosed PSA level inferior to 10 ng/ml, a previous negative prostate biopsy and in therapy with serenoa repens alone or associated to an alpha‐blocker, were retrospectively inserted in an extensive on‐line SIUrO Database. Comprehensive questionnaires were filled in for each patient at 3 and 6 months of follow‐up. Each questionnaire contained various sections, each of them composed by several items: dosed PSA levels, uroflowmetry, International Prostate Symptoms Score (IPSS), International Index of Erectile Function (IIEF‐5), trans‐rectal ultrasound (TRUS) patterns, digital rectal examinations (DRE) aspects, previous prostate bioptical results (histology) and side effects. RESULTS: PSA levels weren't subjected to an increase, revealing a stabilizing or downward trend. Percentage of patients with PSA below the level of 4 ng/mL was lower at the end of the study. The overall changes in the uroflowmetry were similar and parallel both in the group with only serenoa repens intake and in the group with serenoa repens plus alpha‐blocker. The mean medium flow and the mean maximum flow had a slightly increase along the observation time. There was a substantial decreasing in the amount of patients presenting severe prostatic symptoms. Patients reported through the IIEF‐5 score a sexual activity substantially unchanged after 6 months of follow‐up. The serenoa repens intake resulted in an improvement of the "inflammatory‐like reports", in terms of ultrasound patterns, DRE and bioptical features. CONCLUSIONS: serenoa repens demonstrated its efficacy reducing dysuria with minimal side effects. Further prospective studies might confirm its stabilization or lowering role on PSA levels in this cohort of patients and its possible clinical anti‐inflammatory action. PMID: 23210402 [PubMed ‐ indexed for MEDLINE] Curr Opin Urol. 2013 Jan;23(1):38‐41. doi: 10.1097/MOU.0b013e32835abd05. Nutrition and benign prostatic hyperplasia. Espinosa G. SourceDepartment of Urology, NYU Langone Medical Center, New York, New York, USA. [email protected] Abstract PURPOSE OF REVIEW: Nutrition seems to modify the pathogenesis of benign prostatic hyperplasia (BPH) effect symptomology in men suffering from lower urinary tract symptoms (LUTS). Although there are numerous pharmaceuticals and procedures for these conditions, nutrition may improve outcomes as a primary approach or in tandem with BPH medications or procedures. The purpose of this review is to highlight the benefits of nutrition and dietary supplements in men with BPH and LUTS. RECENT FINDINGS: Dietary factors have an impact on metabolic disorders that lead to diabetes and obesity ‐ both of which inversely effect BPH and LUTS. Dietary patterns associated with increased risks include starches and red meats, whereas moderate alcohol intake and polyunsaturated fat and vegetable consumption decrease risks. Dietary supplements of zinc, saw palmetto, and beta‐sitosterol in relieving BPH symptoms have had mixed results. Randomized clinical trials of nutritional practices and other lifestyle alterations such as exercise for the prevention or treatment of BPH and LUTS have yet to be performed. SUMMARY: Nutritional practices may provide for the prevention and treatment of BPH and LUTS while positively affecting other systemic parameters. Whereas there are a few clinical randomized trials for the prevention and treatment of BPH and LUTS, nutritional modifications may have a healthy lifestyle alternative with minimal to no adverse effects. Cochrane Database Syst Rev. 2012 Dec 12;12:CD001423. doi: 10.1002/14651858.CD001423.pub3.