Comparison of Serenoa repens With Tamsulosin in the Treatment of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Abstract

Studies reported that Serenoa repens was effective in relieving lower urinary tract symptoms (LUTS). This article carried out a systematic review and meta-analysis to compare Serenoa repens with tamsulosin in the treatment of benign prostatic hyperplasia (BPH) after at least 6-month treatment cycle. Four studies involving 1,080 patients (543 in the Serenoa repens group and 537 in the tamsulosin group) were included in the meta-analysis. The results were as follows: compared with tamsulosin, Serenoa repens had a same effect in treating BPH in terms of International Prostate Symptom Score (IPSS) (mean difference [MD] 0.63, 95% confidence interval [CI] [−0.33, 1.59], p = 0.20), quality of life (QoL) (MD 1.51, 95% CI [−1.51, 4.52], p = 0.33), maximum flow rate (Qmax) (MD 0.27, 95% CI [−0.15, 0.68], p = 0.21), postvoid residual volume (PVR) (MD −4.23, 95% CI [−22.97, 14.44], p = 0.65), prostate-specific antigen (PSA) (MD 0.46, 95% CI [−0.06, 0.97], p = 0.08) with the exception of prostate volume (PV) (MD −0.29, 95% CI [−0.41, −0.17], p < 0.00001). For side effects, Serenoa repens was well tolerated compared with tamsulosin especially in ejaculation disorders (odds ratio [OR] = 12.56, 95% CI [3.83, 41.18], p < 0.0001) and decreased libido (OR = 5.40; 95% CI [1.17, 24.87]; p = 0.03). This study indicated that Serenoa repens had the same effect in treating BPH compared with tamsulosin in terms of IPSS, QoL, and PVR after at least 6-month treatment cycle, however, the latter had a greater improvement in PV compared with the former. And Serenoa repens did not increase the risk of adverse events especially with respect to ejaculation disorders and libido decrease.

Dietary Factors and Supplements Influencing Prostate-Specific Antigen (PSA) Concentrations in Men with Prostate Cancer and Increased Cancer Risk: An Evidence Analysis Review Based on Randomized Controlled Trials

“…Similarly, compared with tamsulosin [ 125 , 128 , 129 ], saw palmetto did not have a significant effect on PSA concentrations after 6 [ 128 ] and 12 [ 130 ] months of supplementation. Moreover, according to a recent Chinese meta-analysis [ 131 ], saw palmetto was more effective in reducing PSA concentrations among men with BPH as compared with tamsulosin; however, in this analysis, non-randomized trials were analyzed together with RCTs. Moreover, combined tamsulosin and saw palmetto therapy were also inefficient in reducing PSA compared with tamsulosin alone [ 129 ].…”

Saw Palmetto Therapy for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia Assessment in Iraq

“…Controversy data obtained from several previous reviews, data from early review stated that Saw Palmetto extract (Serenoa repens) alone, at double and triple doses, did not significantly decrease nightly urination on the AUA, peak urine flow, or prostate size in men with lower urinary tract symptoms consistent with BPH [3] . A study involving more than one thousand patients (55-80) years old with IPSS ≥ 7, to compare Saw Palmetto extract with tamsulosin in BPH therapy after at six month,also, Serenoa repens used for the same purpose due to it has the same effect in BPH therapy in terms of IPSS (p = 0.20), QoL (p = 0.33), Qmax (p = 0.21), PVR (p = 0.65), and PSA (p = 0.08) [12].…”

The Therapeutic Potential of Saw Palmetto Extract in Urological Disorders

“…For adverse events, SPE was well tolerated compared with tamsulosin, especially in ejaculation disorders and libido decrease. 17 Wyatt et al pointed out that SPE may be a safe herbal supplement, even at a dose of 960 mg daily. 18 Moreover, a multicenter, randomized, double-blind, placebo-controlled trial performed by Zhang et al showed that SPE was effective and safe for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS); only minor side effects such as nausea and stomach discomfort were observed.…”