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BENIGN
PROSTATIC HYPERPLASIA |
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Proscar is prescribed to help shrink an enlarged prostate.
The prostate, a chestnut-shaped gland present in males,
produces a liquid that forms part of the semen. This
gland completely encloses the upper part of the urethra,
the tube through which urine flows out of the bladder.
Many men over age 50 suffer from a benign (noncancerous)
enlargement of the prostate. The enlarged gland squeezes
the urethra, obstructing the normal flow of urine.
Resulting problems may include difficulty in starting
urination, weak flow of urine, and the need to urinate
urgently or frequently. Sometimes surgical removal
of the prostate is necessary. By shrinking the enlarged
prostate, Proscar may alleviate the various associated
urinary problems, making surgery unnecessary.
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Scientific Research Institute
of Urology, Moscow, Russia.
Permixon, the lipidosterolic extract
of Serenoa repens, is widely used for the treatment
of symptoms associated with benign prostatic hyperplasia
(BPH). This open study assessed the efficacy and tolerability
of Permixon 160 mg twice daily administered for 2
years. One hundred fifty-five men with clinically
diagnosed BPH and complaints of prostatic symptoms
were enrolled in the study. At 6, 12, 18, and 24 months,
the International Prostate Symptom Score (I-PSS),
quality of life, and sexual function score were recorded,
and urodynamics and biologic values were measured.
Adverse events were recorded every 3 months. I-PSS
and quality of life improved significantly from baseline
at each evaluation time point. At the end of the study
and at each evaluation, maximum urinary flow also
improved significantly. Prostate size decreased. Sexual
function remained stable during the first year of
treatment and significantly improved (P = .001) during
the second year. Prostate-specific antigen was not
affected, and no changes in plasma hormone levels
were observed. Nine patients reported 10 adverse events,
none related to treatment. Improvements in efficacy
parameters began at 6 months and were maintained up
to 24 months. These data demonstrate the long-term
efficacy and tolerability of Permixon and support
its use as a first-line medical therapy for uncomplicated
symptomatic BPH.
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Center for Holistic Urology,
New York Presbyterian Hospital, and Columbia University
School of Medicine, College of Physicians and Surgeons,
New York, NY, USA.
Benign prostatic hyperplasia (BPH)
is a common problem among aging men that produces
significant morbidity and health care costs. Contention
exists as to whether currently available surgical
and pharmacologic options for BPH are appropriate
for men in the watchful-waiting stage. Recently, the
possible benefits of phytotherapies (plant-derived
preparations) in treating BPH and prostate cancer
are being considered. Several phytotherapies, including
saw palmetto, Pygeum africanum, curbicin, and isoflavone-containing
supplements (red clover [Trifoleum pratense] and soy),
are widely used in patients with BPH. Evidence suggests
that the consumption of isoflavones found in legumes
is related to lower rates of BPH and prostate cancer
among Asian men. When evaluating natural therapies,
the physician should look for a product that relieves
symptoms and is safe, contains a health-conferring
ingredient with a defined mechanism of action, and
is standardized for that ingredient. Phytotherapies,
particularly isoflavone-containing supplements, are
likely to have an important role in the management
of patients in the watchful-waiting stage of BPH.
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