(Sponsored by Medical Utilization Management, L.L.C.)
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SAW PALMETTO The effects of saw palmetto have been assessed on voiding symptoms and urodynamic parameters in men with benign prostatic hypertrophy. A variety of potential mechanisms of action of saw palmetto have been demonstrated through in vitro studies, including 5-alpha reductase inhibition, adrenergic receptor antagonism and intraprostatic androgen receptor blockade. In clinical studies prostate epithelial contraction was noted, especially in the transitional zone. Evidence suggests that saw palmetto may have a significant effect on urinary flow rates and symptom scores. Optimal symptomatic improvement is seen within six months. Some studies have been limited by methodological flaws, small patient numbers and brief treatment intervals. Large scale, placebo controlled trials are needed. No significant adverse effects have been documented, and erectile dysfunction is less with saw palmetto (1.1%) than with finasteride (4.9%). References Gerber GS et al. Saw palmetto (Serona repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Yrology 1998 Jun;51(6):1003-7. Wilt TJ et al. Saw palmetto extracts for the treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998 Nov 11;280(18):1094-9. McPartland JM et al. Benign prostatic hyperplasia treated with saw palmetto: a literature search and an experimental case study. J Am Osteopath Assoc 2000 Feb;100(2):89-96. Gerber GS. Saw palmetto for the treatment of men with lower urinary tract symptoms. J Urol 2000 May;163(5):1408-12. Marks LS et al. Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol 2000 May;163(5):1451-6. |
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