Medical expert of the article
New publications
Alternative treatment of prostate adenoma
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Alternative treatment of prostatic adenoma and urinary disorders has been used for a long time. Now, herbal preparations are most popular in Germany, Austria, Switzerland, France, Italy, Spain and Japan. According to modern ideas, the effectiveness of herbal medicines ensures the maintenance of phytosterols in them, the most important of which are sitosterols. As prospective mechanisms of exposure to sitosterols in prostatic adenoma (prostate), consider:
- inhibition of the synthesis of prostaglandins (inflammatory mediators) in the prostate and providing an anti-inflammatory effect;
- decrease in the production of globulin, which binds testosterone in the liver;
- cytotoxic effect on hyperplastic cells of the prostate:
- inhibiting effect on 5-a-reductase, aromatase and blocking effect on androgen receptors.
Thus, preparations based on Serenoa repens extracts have a complex anti-androgen-antiproliferative effect on the adenoma of the prostate (prostate gland). The complex anti-inflammatory effect of herbal preparations based on Serenoa repens is due to the ability of the extract to inhibit the synthesis of prostaglandins (inflammatory mediators) by inhibiting the synthesis of phospholipase A 2, which actively participates in the conversion of phospholipids to arachidonic acid, as well as inhibition of cyclooxygenase (decreased production of prostaglandins) and lipoxygenase leukotrienes). In addition, Serenoa repens extract has a pronounced anti-edema effect, affecting the vascular phase of inflammation, capillary permeability and vascular stasis. The clinical results of the use of Serenoa repens extract indicate a positive effect in most patients.
Permixon is the original preparation of the French company Pierre Fabre Medication, which has proved itself in many countries of the world for the treatment of prostate adenoma (benign prostatic hyperplasia) and chronic abacterial prostatitis. Permixon is an n-hexane lipidosterol extract of the American dwarf palm Serenoa repens, has a non-competitive inhibitory effect against 5-a-reductase I and II types, local antiproliferative and anti-inflammatory effects. Unlike other drugs based on the same plant material, permixone is characterized by a certified US Food and Drug Administration (FDA) manufacturing process and the highest inhibition index of 5-a-reductase.
The efficacy of permixone in patients with prostate adenoma is confirmed by evidence-based medicine (category of evidence 1A) and manifests itself by a significant decrease in obstructive and irritative symptoms of prostate adenoma (prostate), improvement in urination, and a decrease in residual urine volume. In comparative studies, it was shown that permixone is equivalent in effectiveness to a 5-a-reductase inhibitor finasteride and the most widely used a1-adrenoblocker tamsulosin, whereas treatment is accompanied by a lower incidence of side effects. It is proved that with long-term administration (5 years) permixon significantly reduces the volume of the prostate and the volume of residual urine, and also completely controls the symptoms of prostate adenoma (prostate gland). Characterized by excellent portability and safety.
The treatment of prostate adenoma with Serenoa Revers is not associated with serious side effects. The effect of Serenoa repens treatment on sexual function has not been documented. Serenoa cerevis extract does not affect the hypothalamic-pituitary system, does not have estrogenic or anti-estrogenic effects, does not interact with endogenous estrogens, and lacks progesterone effects. In addition, the drug does not affect the level of PSA.
Preparations based on Serenoa repens do not change blood pressure because of this they do not have an antihypertensive effect and are not restricted when used in people whose activities are related to the management of precise mechanisms and the like. The existing experience of prolonged use of Serenoa repens (for 5 years) has not revealed any significant adverse reactions, this fact once again confirms the high safety profile of this drug for long-term therapy.
The recommended duration of treatment for prostate adenoma with preparations based on Serenoa repens extract is 3 months or more.
Prostamol Uno is a herbal preparation based on the extract of the fruits of the Sabal palm (Serenoa repens). Has anti-inflammatory, anti-exudative, anti-androgenic effects. The antiandrogenic effect is realized due to inhibition of 5-a-reductase (I and II type) and aromatase, blocking the fixation of dehydrotestosterone to cytosolic receptors, which prevents the penetration of the hormone into the nuclei of cells in the prostate tissue and leads to a decrease in the synthesis of dihydotestosterone. Anti-inflammatory and anti-exudative effects are realized by inhibiting the enzymes of the cascade of arachidonic acid: phospholipase A1, cyclooxygenase and 5-lipoxygenase, which in turn leads to a decrease in the production of inflammatory enzymes (prostaglandins and leukotrienes).
Prostamol Uno has a high level of safety: does not change the level of blood pressure, does not affect the level of sex hormones and PSA in the blood, does not change the sexual function.
[Contraindications
Individual intolerance of the drug and its components.
Dosing and Administration: 1 capsule - 1 time per day, not chewing. With a small amount of liquid after eating. Recommended continuous treatment course - at least 3 months.
Lipidosterol extract of the tree bark Pygeum africanum is widely used in clinical practice. The active substance of this complex preparation has not been isolated. Finally, the mechanism of action has not been studied. In studies of the effect of Pygeum africanum extract on prostatic growth factors, it has been established that this agent, with little effect on the spontaneous proliferation of fibroblasts, inhibits their pathological growth. As a result of large-scale international studies on the efficacy of Pygeum africanum extract in the treatment of prostate adenoma, a significant clinical improvement was found in the majority of patients with a minimum of 1.1% side effects.
Materials on the clinical use of other herbal medicines are relatively few, scattered and mostly performed without placebo-control.
Thus, the analysis of data on the use of phytotherapeutic agents in the treatment of prostate adenoma allows us to state that these drugs can have a positive effect on the subjective and objective manifestations of the disease. Medicines of plant origin can be widely used in urological practice as preventive agents in patients with uncomplicated form of prostate adenoma as an alternative to prolonged dynamic observation. More extensive studies are needed to objectively evaluate the efficacy and determine the location of each of the phytotherapeutic agents and their combinations in the structure of treatment for prostate adenoma.
The use of amino acid complexes for the treatment of patients with prostatic adenoma currently has no scientific justification and is based on empirical evidence.
There is evidence that. That preparations extracts of genital organs of cattle improve the detrusor's contractile ability, reduce the concentration of the sphincter and improve their interaction and increase Qmax. These data should be carefully checked.
One of the safest drugs for the treatment of prostate diseases are bioregulatory peptides (prostatilen), the effectiveness of which is confirmed by numerous experimental and clinical studies.
The use of prostatilen in a daily dose of 100 mg (Vitaprost Forte) in patients with prostate adenoma improves the parameters of urination, reduces obstructive and irritative symptoms, significantly improves the quality of life. The etiopathogenetic mechanism of Vitaprost Forte's action on prostatic adenoma is manifested in the preservation and development of the therapeutic effect at the end of the course of treatment.
It is important to note that in 75-95% of patients with prostatic adenoma there is a concomitant chronic prostatitis, which aggravates the clinical course of the underlying disease. Vitaprost Forte reduces the activity of the concomitant inflammatory process in the prostate and thereby improves the effectiveness of the treatment.
Vitaprost Forte does not change blood pressure, the level of sex hormones, preserves potency and libido.
Indications for use: prostate adenoma, condition before and after surgery on the prostate, chronic prostatitis.
Form of release Vitaprost Forte: suppositories rectal № 10.
Dosing and Administration: rectally, 1 suppository once a day. The minimum duration of treatment with Vitaprost Forte for benign prostatic hyperplasia is 15 days, for chronic prostatitis, 10 days.
Thus, the drug alternative treatment of prostate adenoma is an important element in the treatment structure of this disease, it can be used in patients with clinically significant symptoms of the disease with a slight or moderate severity of infravesical obstruction of the dynamic type. At the same time, despite the variety of drugs used to treat prostate adenoma at the present time, the criteria for selecting patients for medical treatment of prostate adenoma have not been developed yet, and there are no clear indications for prescribing a particular drug in a specific clinical situation. This problem is one of the most important in the treatment of prostate adenoma and should be the subject of special scientific research.