Phytotherapy: emerging therapeutic option in urologic disease

Sae Woong Kim, Sae Woong Kim

Abstract

Phytotherapy belongs to the area of complementary and alternative medicine (CAM) and the definition of phytotherapy is the use of plants or plant extracts for medicinal uses. Interest in phytotherapy is growing in both Asian and western countries for its use in the prevention and management of disease, improvement of general health and anti-aging. And also, there are several studies about the efficacy of phytotherapy in urologic diseases like benign prostatic hyperplasia (BPH), erectile dysfunction (ED), late-onset hypogonadism (LOH) and infertility in males. Phytotherapy for BPH including saw palmetto, pygeum, and nettles, is under vigorous research for the therapeutic effect. No solid evidence showing better effective treatment modality for ED than placebo has been found yet for phytotherapy. Recently, a potent NO donor, L-arginine is under research with promising results. Phytotherapy is used by a number of patients with urological disease, and urologists need to have accurate knowledge about phytotherapy as well as keep a cautious approach. The possible effects and side effects should be defined and related to urologic patients by urologists.

Keywords: Phytotherapy; benign prostatic hyperplasia (BPH); complementary and alternative medicine (CAM); erectile dysfunction (ED); infertility; late-onset hypogonadism (LOH); urologic disease.

Conflict of interest statement

Conflicts of Interest: The author has no conflicts of interest to declare.

References

    1. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow up national survey. JAMA 1998;280:1569-75.
    1. Elder NC, Gillcrist A, Minz R. Use of alternative health care by family practice patients. Arch Fam Med 1997;6:181-4.
    1. Gulla J, Singer AJ, Gaspari R. Herbal use in emergency department patients. Ann Emerg Med 2000;35:226-8.
    1. Fairfield KM, Eisenberg DM, Davis RB, et al. Patterns of use, expenditure, and perceived efficacy of complimentary and alternative therapies in HIV-infected patients. Arch Intern Med 1998;158:2257-64.
    1. Kaufman DW, Kelly JP, Rosenberg L, et al. Recent patterns of medication use in the ambulatory adult population of the United States. The Slone survey. JAMA 2002;287:337-44.
    1. Jordan SA, Cunningham DG, Marles RJ. Assessment of herbal medicinal products: challenges, and opportunities to increase the knowledge base for safety assessment. Toxicol Appl Pharmacol 2010;243:198-216.
    1. Kalia, AN. Text Book of Industrial Pharmacognosy. London: Oscar publication. 2005.
    1. Chung KF, McCusker M, Page P, et al. Effect of a ginkgolide mixture (BN 52063) in antagonising skin and platelet responses to platelet activating factor in man. Lancet 1987;1:248-51.
    1. Wagner H. New targets in the Phytopharmacology of Plants. In: Herbal medicine, a concise overview for healthcare professionals. Butterworth-Heinemann 1999:34-42.
    1. Dreikorn K. Complementary and alternative medicine in urology. BJU Int 2005;96:1177-84.
    1. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (PermixonR) with finasteride in the treatment of benign prostate hyperplasia: a randomised international study of 1,098 patients. Prostate 1996;29:231-40.
    1. Debruyne F, Koch G, Boyle P, et al. Comparison of a phytotherapeutic agent (Permixon) with an a-blocker (Tamsulosin) in the treatment of benign prostatic hyperplasia: a 1-year randomised international study. Eur Urol 2002;41:497-506; discussion 506-7.
    1. Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med 2006;354:557-66.
    1. Anceschi R, Bisi M, Ghidini N, et al. Serenoa repens (Permixon) reduces intra- and postoperative complications of surgical treatments of benign prostatic hyperplasia. Minerva Urol Nefrol 2010;62:219-23.
    1. MacDonald R, Ishani A, Rutks I, et al. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. BJU Int 2000;85:836-41.
    1. Habib FK, Ross M, Buck AC, et al. In vitro evaluation of the pollen extract, cernitin T-60, in the regulation of prostate cell growth. Br J Urol 1990;66:393.
    1. Kimura M, Kimura I, Nakase K, et al. Micturition activity of pollen extract: contractile effects on bladder and inhibitory effects on urethral smooth muscle of mouse and pig. Planta Med 1986;52:148-51.
    1. Talpur N, Echard B, Bagchi D, et al. Comparison of Saw Palmetto (extract and whole berry) and Cernitin on prostate growth in rats. Mol Cell Biochem 2003;250:21-6.
    1. Aoki A, Naito K, Hashimoto O, et al. Clinical evaluation of the effect of tamsulosin hydrochloride and cernitin pollen extract on urinary disturbance associated with benign prostatic hyperplasia in a multicentered study. Hinyokika Kiyo 2002;48:259-67.
    1. Ishani A, MacDonald R, Nelson D, et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med 2000;109:654-64.
    1. Boulbès D, Soustelle L, Costa P, et al. Pygeum africanum extract inhibits proliferation of human cultured prostatic fibroblasts and myofibroblasts. BJU Int 2006;98:1106-13.
    1. Lawson RK. Role of growth factors in benign prostatic hyperplasia. Eur Urol 1997;32:22-7.
    1. Choo MS, Bellamy F, Constantinou CE. Functional evaluation of Tadenan on micturition and experimental pros tate growth induced with exogenous dihydrotestosterone. Urology 2000;55:292-8.
    1. Dedhia RC, McVary KT. Phytotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 2008;179:2119-25.
    1. Lopatkin N, Sivkov A, Walther C, et al. Long-term efficacy and safety of a combination of sabal and Urtica extract for lower urinary tract symptoms- a placebo-controlled, double-blind, multicenter trial. World J Urol 2005;23:139-46.
    1. Lopatkin N, Sivkov A, Schläfke S, et al. Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms--long-term follow-up of a placebo-controlled, double-blind, multicenter trial. Int Urol Nephrol 2007;39:1137-46.
    1. Sikora R, Sohn MH, Deutz F-J, et al. Ginkgo biloba extract in the therapy of erectile dysfunction. J Urol 1989;141:188A (Abstract 73).
    1. Sikora R, Sohn MH, Engelke B, et al. Randomized placebo-controlled study on the effects of oral treatment with Ginkgo biloba extract in patients with erectile dysfunction. J Urol 1998;159:240A (Abstract 917).
    1. Solomon PR, Adams F, Silver A, et al. Ginkgo for memory enhancement: a randomized controlled trial. JAMA 2002;288:835-40.
    1. Choi YD, Xin ZC, Choi HK. Effect of Korean red ginseng on the rabbit corpus cavernosal smooth muscle. Int J Impot Res 1998;10:37-43.
    1. Hong B, Ji YH, Hong JH, et al. A doubleblind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol 2002;168:2070-3.
    1. Lue TF, Lee KL. Pharmacotherapy for erectile dysfunction. Chin Med J (Engl) 2000;113:291-8.
    1. Toda N, Ayajiki K, Okamura T. Nitric oxide and penile erectile function. Pharmacol Ther 2005;106:233-66.
    1. Zorgniotti AW, Lizza AF. Effect of large doses of nitric oxide precursor L-arginine, on erectile dysfunction. Int J Impot Res 1994;6:33-5.
    1. Klotz T, Mathers MJ, Braun M, et al. Effectiveness of oral L-arginine in the first-line treatment of erectile dysfunction in a controlled crossover study. Urol Int 1999;63:220-3.
    1. Chen J, Wollman Y, Chernichovsky T, et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int 1999;83:269-73.
    1. Xin ZC, Kim EK, Lin CS, et al. Effects of icariin on cGMPspecific PDE5 and cAMP-specific PDE4 activities. Asian J Androl 2003;5:15-8.
    1. Ning H, Xin ZC, Lin G, et al. Effects of icariin on phosphodiesterase-5 activity in vitro and cyclic guanosine monophosphate level in cavernous smooth muscle cells. Urology 2006;68:1350-4.
    1. Chye PH. Traditional Asian folklore medicines in sexual health. Indian J Urol 2006;22:241-5.
    1. Zamble A, Carpentier M, Kandoussi A, et al. Paullinia pinnata extracts rich in polyphenols promote vascular relaxation via endothelium-dependent mechanisms. J Cardiovasc Pharmacol 2006;47:599-608.
    1. Bogani P, Simonini F, Iriti M, et al. Lepidium meyenii (Maca) does not exert direct androgenic activities. J Ethnopharmacol 2006;104:415-7.
    1. Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Saf 2002;25:323-344.
    1. Choudhary I, Ur-Rahman A. Elixirs of love. Chem Br 1997;25-27.
    1. Samuelsson G. Drugs of natural origin: a textbook of pharmacognosy. 4th ed. Stockholm: Swedish Pharmaceutical 1999;171.
    1. Tode T, Kikuchi Y, Hirata J, et al. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet 1999;67:169-74.
    1. Wiklund IK, Mattson LA, Lindgren R, et al. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group. Int J Clin Pharmacol Res 1999;19:89-99.
    1. Sung J, Han KH, Zo JH, et al. Effects of red ginseng upon vascular endothelial function in patients with essential hypertension. Am J Chin Med 2000;28:205-16.
    1. Zheng HZ, Dong ZH, She Q. Modern research and application of traditional Chinese medicine. Beijing: Xueyuan, 1998: 4225-54.
    1. Chiu JH, Chen KK, Chien TM, et al. Epimedium brevicornum Maxim extract relaxes rabbit corpus cavernosum through multitargets on nitric oxide/cyclic guanosine monophosphate signaling pathway. Int J Impot Res 2006;18:335-42.
    1. Panossian A, Wikman G. Pharmacology of Schisandra chinensis Bail: an overview of Russian research and uses in medicine. J Ethnopharmacol 2008;118:183-212.
    1. Sohn DW, Kim HY, Kim SD, et al. Elevation of intracavernous pressure and NO-cGMP activity by a new herbal formula in penile tissues of spontaneous hypertensive male rats. J Ethnopharmacol 2008;120:176-80.
    1. Park JY, Shin HK, Lee YJ, et al. The mechanism of vasorelaxation induced by Schisandra chinensis extract in rat thoracic aorta. J Ethnopharmacol 2009;121:69-73.
    1. Han DH, Lee JH, Kim H, et al. Effects of Schisandra chinensis extract on the contractility of corpus cavernosal smooth muscle (CSM) and Ca2+ homeostasis in CSM cells. BJU Int 2012;109:1404-13.
    1. Lunenfeld B, Saad F, Hoesl CE. ISA, ISSAM and EAU recommendations for the investigation, treatment and monitoring of late-onset hypogonadism in males: scientific background and rationale. Aging Male 2005;8:59-74.
    1. Comhaire FH. Andropause: hormone replacement therapy in the aging male. Eur Urol 2000;38:655-62.
    1. Yan W, Ohtani K, Kasai R, et al. Steroidal saponins from fruits of Tribulus terrestris. Phytochemistry 1996;42:1417-22.
    1. Bedir E, Khan IA. New steroidal glycosides from the fruits of Tribulus terrestris. J Nat Prod 2000;63:1699-701.
    1. Cai L, Wu Y, Zhang J, et al. Steroidal saponins from Tribulus terrestris. Planta Med 2001;67:196-8.
    1. Adimoelja A. Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions. Int J Androl 2000;23:82-4.
    1. Arcasoy HB, Erenmemisoglu A, Tekol Y, et al. Effect of Tribulus terrestris L. saponin mixture on some smooth muscle preparations: a preliminary study. Boll Chim Farm 1998;137:473-5.
    1. Adaikan PG, Gauthaman K, Prasad RN, et al. Proerectile pharmacological effects of Tribulus terrestris extract on the rabbit corpus cavernosum. Ann Acad Med Singapore 2000;29:22-6.
    1. Antonio J, Uelmen J, Rodriguez R, et al. The effects of Tribulus terrestris on body composition and exercise performance in resistance-trained males. Int J Sport Nutr Exerc Metab 2000;10:208-15.
    1. Gauthaman K, Adaikan PG, Prasad RNV. Aphrodisiac properties of Tribulus Terrestris extract (Protodioscin) in normal and castrated rats. Life Sci 2002;71:1385-96.
    1. Koyama T. Role of Kampo (herbal) medicine for management in postmenopausal women in Japan. J Jpn Menopause Soc 1993;1:75-9.
    1. Amano T, Imao T, Takemae K. Clinical efficacy of Japanese traditional herbal medicine (Kampo) in patients with late-onset hypogonadism. Aging Male 2010;13:166-73.
    1. Devi PR, Laxmi V, Charulata C, et al. ‘‘Alternative medicine’’- a right choice for male infertility management. Int Cong Series 2004;1271:67-70.
    1. Storey BT. Biochemistry of the induction and prevention of lipoperoxidative damage in human spermatozoa. Mol Hum Reprod 1997;3:203-13.
    1. Dhuley JN. Effect of ashwagandha on lipid peroxidation in stressinduced animals. J Ethnopharmacol 1998;60:173-8.
    1. Abdel-Magied EM, Abdel-Rehman HA, Harraz FM. The effect of aqueous extracts of Cynomorium coccineum and Withania somnifera on testicular development in immature Wistar rats. J Ethnopharmacol 2001;75:1-4.
    1. Shukla KK, Mahdi AA, Mishra V, et al. Withania somnifera improves semen quality by combating oxidative stress and cell death and improving essential metal concentrations. Reprod Biomed Online 2011;22:421-7.
    1. Sirtori CR. Aescin: pharmacology, pharmacokinetics and therapeutic profile. Pharmacol Res 2001;44:183-93.
    1. Carrasco OF, Vidrio H. Endothelium protectant and contractile effects of the antivaricose principle escin in rat aorta. Vascul Pharmacol 2007;47:68-73.
    1. Kamischke A, Nieschlag E. Varicocele treatment in the light of evidence-based andrology. Hum Reprod Update 2001;7:65-9.
    1. Fang Y, Zhao L, Yan F, et al. Escin improves sperm quality in male patients with varicocele-associated infertility. Phytomedicine 2010;17:192-6.
    1. Francis FJ. Food colorants: anthocyanins. Crit Rev Food Sci Nutr 1989;28:273-314.
    1. Harborne JB, Wiliam CA. Advances in flavonoid research since 1992. Phytochemistry 2000;55:481-504.
    1. Gorelick JI, Goldstein M. Loss of fertility in men with varicocele. Fertil Steril 1993;59:613-6.
    1. Aitken RJ, Buckingham D, West K, et al. Differential contribution of leucocytes and spermatozoa to the generation of reactive oxygen species in the ejaculates of oligozoospermic patients and fertile donors. J Reprod Fertil 1992;94:451-62.
    1. Jang H, Kim SJ, Yuk SM, et al. Effects of anthocyanin extracted from black soybean seed coat on spermatogenesis in a rat varicocele-induced model. Reprod Fertil Dev 2012;24:649-55.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir