Prostate enlargement — can herbs replace pills and a scalpel?

Aim of the study: and aims: Benign Prostatic hyperplasia (BPH) is an important public health problem. Roughly half of all men will suffer from BPH related symptoms later in life. The prostate gland, a hormone dependent part of the male reproductive system, is susceptible to internal and external disruptions of regulatory systems.

Results: Moderate exercise and the type and amount of protein intake have a considerable influence on BPH symptoms. The intake of zinc and vitamin D also positively influence BPH symptoms, and so do certain supplements, such as saw palmetto, cemilton and pygeum extracts. Lifestyle changes, diet modification and certain nutritional supplements can favorably influence BPH symptoms.

Aim of the study: To systematically review the existing evidence regarding the efficacy and safety of phytotherapeutic compounds used to treat men with symptomatic benign prostatic hyperplasia (BPH).

Results: A total of 44 studies of six phytotherapeutic agents (Serenoa repens, Hypoxis rooperi, Secale cereale, Pygeum africanum, Urtica dioica, Curcubita pepo) met inclusion criteria and were reviewed. Many studies did not report results in a method allowing meta-analysis. Serenoa repens, extracted from the saw palmetto, is the most widely used phytotherapeutic agent for BPH. A total of 18 trials involving 2939 men were reviewed. Compared with men receiving placebo, men taking Serenoa repens reported greater improvement of urinary tract symptoms and flow measures. Serenoa repens decreased nocturia (weighted mean difference (WMD) = -0.76 times per evening; 95% CI = -1.22 to -0.32; n = 10 studies) and improved peak urine flow (WMD = 1.93 ml s(-1); 95% CI = 0.72 to 3.14, n = 8 studies). Men treated with Serenoa repens rated greater improvement of their urinary tract symptoms versus men taking placebo (risk ratio of improvement = 1.72; 95% CI = 1.21 to 2.44, n = 8 studies).

Aim of the study: Benign prostatic hyperplasia is a common condition affecting older men. Typical presenting symptoms include urinary hesitancy, weak stream, nocturia, incontinence, and recurrent urinary tract infections.

Results: Limited evidence shows that the herbal agents saw palmetto extract, rye grass pollen extract, and pygeum relieve symptoms. Transurethral resection of the prostate often provides permanent relief. Newer laser-based surgical techniques have comparable effectiveness to transurethral resection up to two years after surgery with lower perioperative morbidity. Various outpatient surgical techniques are associated with reduced morbidity, but symptom relief may be less durable.

Aim of the study: Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men, the incidence of which gradually increases with age and leads to lower urinary tract symptoms (LUTS), which seriously affects the quality of life of patients. Chinese herbal medicines (CHMs) are widely used for the treatment of BPH in China and some other countries.

Results: The results suggest that the mechanisms of action of CHMs in treating BPH may involve the regulation of sex hormones, downregulation of cell growth factors, anti-inflammatory and antioxidative effects, inhibition of cell proliferation, and promotion of apoptosis. CHMs also exhibit α-blocker-like effects, with the potential to relax urethral smooth muscle and alleviate LUTS. Additionally, we also reviewed 4 clinical trials and meta-analyses of CHMs for the treatment of BPH patients, which provided initial evidence of the safety and effectiveness of CHMs treatment. CHMs treatment for BPH shows advantages as a multi-component, multi-target, and multi-pathway therapy, which can mitigate the severity of the disease, improve LUTS, and may become a reliable treatment option in the future.

Aim of the study: Benign prostatic hyperplasia (BPH) can affect quality of life and cause various complications. Previous studies have suggested that Chinese herbal medicine can alleviate symptoms in patients with BPH. This study aimed to investigate whether the Chinese herbal medicine prescription VGH-BPH1 can alleviate BPH symptoms when used as an add-on treatment.

Results: VGH-BPH1 treatment significantly decreased the International Prostate Symptoms Score total score (p = 0.027); however, no significant difference was observed between the treatment and placebo groups. The Aging Male Symptoms Score "joint pain and muscular ache" score in the VGH-BPH1 group was significantly lower than that of the placebo group (p = 0.022). The "physical exhaustion" score also exhibited a decreasing trend when both groups were compared (p = 0.057). Although VGH-BPH1 treatment did not outperform the placebo in terms of improving BPH symptoms, it resulted in improvement in several quality of life indicators when relative to the placebo. Future research using a larger sample size with appropriate amendments to the protocol should be conducted to further investigate the effects of VGH-BPH1.

Aim of the study: Anti-inflammatory and antioxidant effects play crucial roles in the recovery of benign prostatic hyperplasia (BPH). Wenshenqianlie (WSQL) capsule, a typical traditional Chinese medicine formulation combining 14 Chinese herbs, has been reported to exert tonic effects on the kidneys and improve clinical symptoms of BPH.

Results: We investigated the anti-inflammatory and antioxidant effect and mechanism of WSQL on BPH via histopathological examination, immunohistochemistry, enzyme-linked immunosorbent assay, and western blotting combined with in vivo serum metabolomics, gut microbiomics analysis. WSQL alleviated prostate hyperplasia and reduced prostate-specific antigen, dihydrotestosterone, testosterone, and inflammation levels. Gut microbiomics and serum non-targeted metabolomics determined that the protective effect of WSQL against BPH may be related to the improvement of inflammation and testosterone-related gut microbiota and serum metabolites. Further studies showed that WSQL ameliorated nuclear factor-kappa B, its downstream inflammatory factors, and nuclear factor E2-related factor 2 pathway.

Aim of the study: Background/Objectives: Benign prostatic hyperplasia (BPH) is a common age-related disorder in elderly men and a major cause of lower urinary tract symptoms. Lycopus lucidus Turcz.

Results: Expression of 5α-reductase type 2 and aromatase in the ventral prostate tissue was significantly downregulated, while Bax and Bcl-2 expression and the Bax/Bcl-2 ratio remained unchanged. Conclusions: LLE attenuated TP-induced prostatic hyperplasia in rats, suggesting that modulation of androgen metabolism may contribute to its anti-hyperplastic effects. These findings support further investigation of L. lucidus extract in BPH.

Aim of the study: Clinically employed for benign prostatic hyperplasia management, the Qianlong Shutong Formula (QLSTF) represents an empirical therapeutic preparation, exhibiting properties of heat clearance, diuretic promotion, blood circulation activation, and nodule resolution. However, its molecular mechanisms in regulating inflammation and fibrosis remain unclear.

Results: The findings indicated that QLSTF markedly diminished the extent of prostatic hyperplasia, facilitated death of hyperplastic cells, and lowered the expression of fibrosis markers in BPH model rats. Concurrently, it inhibited YAP/TAZ migration toward the nuclear compartment and balanced the expression of Th17/Treg, thereby achieving therapeutic effects against BPH. QLSTF can inhibit inflammatory response and interstitial fibrosis by regulating the imbalance of the Th17/Treg-mediated immune-inflammatory microenvironment and the Hippo-YAP/TAZ pathway. Notably, the observed effects correlate with Hippo-YAP/TAZ pathway modulation, though direct causal mechanistic links require further functional validation.

Aim of the study: To investigate the molecular mechanism of Qianlong Shutong formula (QLSTF) in treating benign prostatic hyperplasia (BPH) through the regulation of metabolism and protein function. An integrated metabolomics and proteomics analysis was conducted using a BPH animal model.

Results: Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Clusters of Orthologous Groups (COG) enrichment analyses revealed that these proteins are involved in biological processes such as cell proliferation, apoptosis, and inflammatory responses. Correlation analysis demonstrated a synergistic relationship between metabolite levels and protein expression. Integrated analyses revealed metabolic disorders and differential protein expression, providing multiomics evidence for QLSTF's mechanism. QLSTF alleviates BPH by modulating metabolic pathways and protein networks, providing a molecular basis for TCM in BPH treatment and suggesting future research.