gamma-sitosterol and Prostatic-Hyperplasia

Nutrition seems to modify the pathogenesis of benign prostatic hyperplasia (BPH) effect symptomology in men suffering from lower urinary tract symptoms (LUTS). Although there are numerous pharmaceuticals and procedures for these conditions, nutrition may improve outcomes as a primary approach or in tandem with BPH medications or procedures. The purpose of this review is to highlight the benefits of nutrition and dietary supplements in men with BPH and LUTS.. Dietary factors have an impact on metabolic disorders that lead to diabetes and obesity - both of which inversely effect BPH and LUTS. Dietary patterns associated with increased risks include starches and red meats, whereas moderate alcohol intake and polyunsaturated fat and vegetable consumption decrease risks. Dietary supplements of zinc, saw palmetto, and beta-sitosterol in relieving BPH symptoms have had mixed results. Randomized clinical trials of nutritional practices and other lifestyle alterations such as exercise for the prevention or treatment of BPH and LUTS have yet to be performed.. Nutritional practices may provide for the prevention and treatment of BPH and LUTS while positively affecting other systemic parameters. Whereas there are a few clinical randomized trials for the prevention and treatment of BPH and LUTS, nutritional modifications may have a healthy lifestyle alternative with minimal to no adverse effects.

Topics: Dietary Supplements; Humans; Life Style; Lower Urinary Tract Symptoms; Male; Nutrition Therapy; Plant Extracts; Prostatic Hyperplasia; Secale; Sitosterols

Benign prostatic hyperplasia (BPH) is a common chronic condition in older men. The aim of this overview of systematic reviews (SRs) is to summarise the current evidence on the efficacy and adverse effects of dietary supplements for treating BPH with lower urinary tract symptoms. We searched 5 electronic databases and relevant overviews without limitations on language or publication status. Six SRs of 195 articles were included in this overview. Serenoa repens was reviewed in 3 studies and no specific effect on BPH symptoms and urinary flow measures was observed. However, β-sitosterol, Pygeum africannum and Cernilton were reviewed in one study each, and significant improvement was observed for all three. All the included compounds have mild and infrequent adverse effects. SRs on β-sitosterol, Pygeum africannum and Cernilton have not been updated since 2000, thus an update of reviews on these compounds will be necessary in the future.

Topics: Dietary Supplements; Humans; Male; Phytotherapy; Plant Extracts; Prostatic Hyperplasia; Prunus africana; Secale; Serenoa; Sitosterols; Treatment Outcome; Urologic Diseases

Topics: 5-alpha Reductase Inhibitors; Adrenergic alpha-Antagonists; Humans; Lolium; Male; Phytotherapy; Plant Extracts; Pollen; Prostatic Hyperplasia; Serenoa; Sitosterols; Transurethral Resection of Prostate

Topics: 5-alpha Reductase Inhibitors; Adrenergic alpha-Antagonists; Adult; Humans; Lolium; Male; Phytotherapy; Plant Extracts; Pollen; Prostatic Hyperplasia; Serenoa; Sitosterols; Transurethral Resection of Prostate

Phytotherapy has become a more popular treatment option among American men with benign prostatic hyperplasia (BPH). The most popular herbal agent is saw palmetto (Serenoa repens), which is derived from the berry of the American dwarf palm tree. Pygeum africanum and beta-sitosterol are also used by many patients with BPH, either alone or in combination with saw palmetto. A significant limiting factor to our understanding of the use and effectiveness of phytotherapy is the lack of standardization of these products. Despite this lack of standardization and the variation in results that may be seen with herbal products, there is growing evidence from well-conducted clinical trials that phytotherapeutic agents may lead to subjective and objective symptom improvement beyond a placebo effect in men with BPH. In addition, histologic evidence has been presented demonstrating that saw palmetto causes atrophy and epithelial contraction within the prostate gland. Overall, it is likely that herbal therapy will continue to be used by a growing number of Americans to treat a variety of ailments. Physicians should attempt to remain open-minded regarding alternative approaches and educate themselves so that they may counsel patients in an informed and credible fashion.

Topics: Androgen Antagonists; Humans; Male; Phytotherapy; Plant Extracts; Pollen; Prostate; Prostatic Hyperplasia; Prunus; Serenoa; Sitosterols; Urodynamics

This systematic review aimed to assess the effects of beta-sitosterols (B-sitosterol) on urinary symptoms and flow measures in men with of benign prostatic hyperplasia (BPH).. Trials were searched in computerized general and specialized databases (MEDLINE, EMBASE, Cochrane Library, Phytodok), by checking bibliographies, and by contacting manufacturers and researchers.. Trials were eligible for inclusion provided they (1) randomized men with BPH to receive B-sitosterol preparations in comparison to placebo or other BPH medications, and (2) included clinical outcomes such as urologic symptom scales, symptoms, or urodynamic measurements.. Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. Main outcome measure for comparing the effectiveness of B-sitosterols with placebo and standard BPH medications was the change in urologic symptom scale scores. Secondary outcomes included changes in nocturia as well as urodynamic measures (peak and mean urine flow, residual volume, prostate size). Main outcome measure for side effects was the number of men reporting side effects.. 519 men from 4 randomized, placebo-controlled, double-blind trials, (lasting 4 to 26 weeks) were assessed. 3 trials used non-glucosidic B-sitosterols and one utilized a preparation that contained 100% B-sitosteryl-B-D-glucoside. B-Sitosterols improved urinary symptom scores and flow measures. The weighted mean difference (WMD) for the IPSS was -4.9 IPSS points (95%CI = -6.3 to -3.5, n = 2 studies). The WMD for peak urine flow was 3.91 ml/sec (95%CI = 0.91 to 6.90, n = 4 studies) and the WMD for residual volume was -28.62 ml (95%CI = -41. 42 to -15.83, n = 4 studies). The trial using 100% B-sitosteryl-B-D-glucoside (WA184) show improvement in urinary flow measures. B-sitosterols did not reduce prostate size. Withdrawal rates for men assigned to B-sitosterol and placebo were 7.8% and 8. 0%, respectively.. The evidence suggests non-glucosidic B-sitosterols improve urinary symptoms and flow measures. Their long term effectiveness, safety and ability to prevent BPH complications are not known.

Topics: Humans; Male; Phytotherapy; Prostatic Hyperplasia; Sitosterols; Urodynamics

To conduct a systematic review of the evidence for the efficacy of beta-sitosterol in men with symptomatic benign prostatic hyperplasia (BPH).. Studies were identified through Medlinetrade mark (1966-98), EMBASEtrade mark, Phytodok, the Cochrane Library, bibliographies of identified trials and review articles, and contact with study authors and pharmaceutical companies. Randomized trials were included if: men had symptomatic BPH; plant extract preparations contained beta-sitosterols; a control group received placebo or a pharmacological therapy; and treatment duration was >/=30 days. Study characteristics, demographic information, enrolment criteria and outcomes were extracted.. Four trials comprising a total of 519 men met the inclusion criteria. All were double-blind and lasted 4-26 weeks. Three studies used nonglucosidic beta-sitosterols and one used a preparation that contained only beta-sitosterol-beta-d-glucoside. Compared with placebo, beta-sitosterol improved urinary symptom scores and flow measures. For the two studies reporting the International Prostate Symptom Score (IPSS), the weighted mean difference (WMD) against placebo was -4.9 IPSS points (95% confidence interval, CI,-6.3 to-3.5). The WMD for peak urinary flow rate was 3.91 mL/s (95% CI 0.91 to 6.90, four studies) and for residual volume the WMD was -28.62 mL (95% CI-41.42 to-15.83, four studies). beta-sitosterol did not reduce prostate size. The trial using pure beta-sitosterol-beta-d-glucoside (WA184) showed no improvement in urinary flow measures. Withdrawal rates for men assigned to beta-sitosterol and placebo were 7.8% and 8.0% (not significant), respectively.. beta-sitosterol improves urological symptoms and flow measures. However, the existing studies are limited by short treatment duration and lack of standardized beta-sitosterol preparations. Their long-term effectiveness, safety and ability to prevent the complications of BPH are unknown.

Topics: Adult; Aged; Aged, 80 and over; Humans; Male; Middle Aged; Prostatic Hyperplasia; Randomized Controlled Trials as Topic; Sitosterols; Treatment Outcome; Urination; Urination Disorders

The present clinical trial was conducted to evaluate the efficacy and tolerability of a standardized saw palmetto oil containing 3% β-sitosterol in the treatment of benign prostate hyperplasia (BPH) and androgen deficiency.. Subjects aged 40-65 years with symptomatic BPH were randomized to 12-week double-blind treatment with 500 mg doses of β-sitosterol enriched saw palmetto oil, conventional saw palmetto oil and placebo orally in the form of capsules (n = 33 in each group). BPH severity was determined using the International Prostate Symptom Score (IPSS), uroflowmetry, serum measurement of prostate specific antigen (PSA), testosterone and 5α-reductase. During the trial, the androgen deficiency was evaluated using Aging Male Symptoms (AMS) scale, the Androgen Deficiency in the Aging Male (ADAM) questionnaire, serum levels of free testosterone.. Subjects treated with β-sitosterol enriched saw palmetto oil showed significant decrease in IPSS, AMS and ADAM scores along with reduced postvoiding residual volume (p < 0.001), PSA (p < 0.01) and 5α-reductase from baseline to end of 12-week treatment as compared to placebo. There was also a significant increment in the maximum and average urine flow rate (p < 0.001), and serum free testosterone level of subjects treated with enriched saw palmetto oil as compared to placebo.. This study demonstrates the efficacy of β-sitosterol enriched saw palmetto oil superior to conventional oil thus extending the scope of effective BPH and androgen deficiency treatment with improved quality of life through the intake of functional ingredients.. CTRI/2018/12/016724 dated 19/12/2018 prospectively registered. URL: http://ctri.nic.in/Clinicaltrials/advsearch.php.

Topics: Adult; Aged; Androgens; Double-Blind Method; Humans; Male; Middle Aged; Phytosterols; Phytotherapy; Plant Extracts; Plant Oils; Prostatic Hyperplasia; Serenoa; Sitosterols; Treatment Outcome; Urological Agents

Because benign prostatic hyperplasia (BPH) is relatively common, it is important to discover safe and effective means to treat this often debilitating perturbation. Accordingly, we examined the effectiveness of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) in treating symptoms of BPH. We undertook a randomized, placebo-controlled, double-blind study. Patients were enrolled from 3 urological practices in the USA. 144 subjects were randomized for study. 17 subjects eventually withdrew, leaving 70 patients in the test group and 57 in the placebo group to complete the study. Inclusion criteria consisted of a diagnosis of BPH, no evidence of cancer, and a maximal urinary flow rate between 5 and 15 ml/second. Patients received either placebo or the combined natural products for 3 months. Evaluations were performed via the American Urological Association (AUA) Symptom Index score, urinary flow rate, PSA measurement, and residual bladder volume. Nocturia showed a markedly significant decrease in severity in patients receiving the combined natural products compared to those taking placebo (p < 0.001). Daytime frequency was also lessened significantly (p < 0.04). When the average individual total AUA Symptom Index score in the test group was compared to that in the placebo group at the end of the study, the difference proved highly significant (p < 0.014). PSA measurements, maximal and average urinary flow rates, and residual volumes showed no statistically significant differences. When taken for 3 months, a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) compared to placebo can significantly lessen nocturia and frequency and diminish overall symptomatology of BPH as indicated by an improvement in the total AUA Symptom Index score. The combination of natural products caused no significant adverse side effects.

Topics: Androgen Antagonists; Biological Products; Double-Blind Method; Humans; Male; Plant Extracts; Prostatic Hyperplasia; Secale; Serenoa; Sitosterols; Urodynamics; Vitamin E

To determine the long-term effects of phytotherapy with beta-sitosterol (the trade name for beta-sitosterol used in this study is Harzol(R)) for symptomatic benign prostatic hyperplasia (BPH). Patient and methods At 18 months after enrolment in a 6-month multicentre double-blind placebo-controlled clinical trial with beta-sitosterol (reported previously), patients were re-evaluated using the modified Boyarsky score, the International Prostate Symptom Score and quality-of-life index, the maximum urinary flow rate (Qmax) and postvoid residual urine volume (PVR). In this open extension of the original trial (after 6 months of treatment or placebo), patients were free to chose their further treatment for BPH.. In all, 117 patients (59%) were eligible for analysis during the follow-up. Of the formerbeta-sitosterol group, 38 patients who continued beta-sitosterol treatment had stable values for all outcome variables between the end of the double-blind study and after 18 months of follow-up. The 41 patients choosing no further therapy had slightly worse symptom scores and PVR, but no changes in Qmax. Of the former placebo group, 27 patients who started beta-sitosterol after the double-blind trial improved to the same extent as the treated group for all outcome variables. The 18 patients choosing no further therapy showed no signs of improvement.. The beneficial effects of beta-sitosterol treatment recorded in the 6-month double-blind trial were maintained for 18 months. Further clinical trials should be conducted to confirm these results before concluding that phytotherapy with beta-sitosterol is effective.

Topics: Double-Blind Method; Follow-Up Studies; Humans; Male; Prostatic Hyperplasia; Quality of Life; Sitosterols; Treatment Outcome

Topics: Administration, Oral; Aged; Dose-Response Relationship, Drug; Double-Blind Method; Humans; Male; Middle Aged; Prostatic Hyperplasia; Sitosterols; Treatment Outcome; Urinary Bladder Neck Obstruction; Urodynamics

Medical treatments have become available for benign hypertrophy of the prostate, including alpha-receptor blocking agents and 5-alpha-reductase inhibitors. Drugs derived from plants, for which no precise mechanism of action has been described, are widely used for this purpose in Europe. In a randomised, double-blind, placebo-controlled multicentre study, 200 patients (recruited between April and October 1993) with symptomatic benign prostatic hyperplasia were treated with either 20 mg beta-sitosterol (which contains a mixture of phytosterols) three times per day or placebo. Primary end-point was a difference of modified Boyarsky score between treatment groups after 6 months; secondary end-points were changes in International Prostate Symptom Score (IPSS), urine flow, and prostate volume. Modified Boyarsky score decreased significantly with a mean of -6.7 (SD 4.0) points in the beta-sitosterol-treated group versus -2.1 (3.2) points in the placebo group p < 0.01. There was a decrease in IPSS (-7.4 [3.8] points in the beta-sitosterol-treated group vs -2.1 [3.8] points in the placebo group) and changes in urine flow parameters: beta-sitosterol treatment resulted in increasing peak flow (15.2 [5.7] mL/s from 9.9 [2.5] mL/s), and decrease of mean residual urinary volume (30.4 [39.9] mL from 65.8 [20.8] mL). These parameters did not change in the placebo group (p < 0.01). No relevant reduction of prostatic volume was observed in either group. Significant improvement in symptoms and urinary flow parameters show the effectiveness of beta-sitosterol in the treatment of benign prostatic hyperplasia.

Topics: Aged; Double-Blind Method; Drug Administration Schedule; Follow-Up Studies; Humans; Male; Placebos; Prostate; Prostatic Hyperplasia; Quality of Life; Sitosterols; Treatment Outcome; Urinary Retention; Urodynamics

Within the scope of a controlled double-blind study to demonstrate the effect of conservative therapy of benign prostatic hyperplasia with Harzol, ultrasonographic examination of the prostate adenoma was carried out on 23 patients before and after therapy with the trial preparation or placebo. Within a two-month treatment with Harzol, there was a significant change in the echo structure of the prostate adenoma, and this is interpreted as a reduction in the interstitial formation of oedema.

Topics: Clinical Trials as Topic; Double-Blind Method; Humans; Male; Prostatic Hyperplasia; Sitosterols; Ultrasonography

Benign prostatic hyperplasia (BPH) is a pathological condition affecting older men. BPH complications often lead to deterioration in the quality of life. Serenoa repens (Saw Palmetto) is used for treating lower urinary tract infections in traditional medicine.. This study was performed to compare the efficacy of β-sitosterol enriched saw palmetto oil (VISPO) and conventional saw palmetto oil (SPO) extracted using supercritical fluid extraction, in alleviating the BPH complications using testosterone-induced BPH model rats. The animals received testosterone (5 mg/kg s.c.) with or without SPO and VISPO (200 and 400 mg/kg b.w.) or Finasteride (1 mg/kg b.w.) p.o. for 28 days. At the end of the experiment, overnight fasted animals were euthanized, blood samples collected for serum analysis of testosterone. Prostate tissue histomorphology was examined by hematoxylin and eosin (H&E) staining. Western blot analysis was performed using prostate tissue homogenates.. VISPO exhibited superior efficacy compared to SPO as evident from the significant decrease in prostate weight to body weight ratio, serum testosterone level and increase in growth inhibition of prostate tissue compared to BPH group (p < 0.001). Histological examination of prostate tissue samples showed that VISPO treatment was comparatively better than SPO in improving the hyperplastic patterns. Further, VISPO significantly regulated the expression of inflammatory and apoptotic marker proteins in BPH rats.. Our data provide experimental evidence that β-sitosterol enriched saw palmetto oil could be higher efficacious in treating the BPH complications compared to the conventional saw palmetto oil preparations.

Topics: Animals; bcl-2-Associated X Protein; Chromatography, Supercritical Fluid; Humans; Male; Phytosterols; Phytotherapy; Plant Extracts; Prostate; Prostatic Hyperplasia; Proto-Oncogene Proteins c-bcl-2; Rats; Rats, Wistar; Serenoa; Sitosterols; Testosterone

The bark of Prunus africana may contain atranorin, atraric acid, beta-sitosterol and its esters, ferulic acid and its esters, and N-butylbenzene sulfonamide, compounds that have been shown to improve the conditions of benign prostatic hyperplasia, enlarged prostate. An analytical scheme, involving liquid-solid extractions, saponifications, and LC-APCI-MS (triple quadrupole) analysis, was developed, optimized, and validated to determine the compounds at μg/g levels. Limits of quantification were in the low ng/mL range except for beta-sitosterol. All of the compounds plus two internal standards eluted in under 10 min on a phenyl-hexyl column with gradient elution involving water-methanol and acetonitrile. The mass fraction of the compounds in Prunus africana bark (four samples) and commercial pygeum products (seven samples), derived from bark, were compared. Bark and pygeum were similar in their content of atranorin and atraric acid, found at low μg/g levels, and in the fact that ferulic acid was almost totally (> 90%) in the form of esters. In contrast, the total amount of ferulic acid was on average four times higher in bark (450 μg/g) than in pygeum while the opposite was true for total beta-sitosterol. Some pygeum samples had levels of total beta-sitosterol above 10,000 μg/g while the compound in bark was relatively invariant at about 680 μg/g. The fraction of free beta-sitosterol varied significantly between bark (33%) and pygeum (nearly all). In pygeum, the measured total beta-sitosterol concentration generally followed the labeled values for phytosterol content. No N-butylbenzene sulfonamide was found in any of the bark and pygeum samples.

Topics: Chemical Fractionation; Chromatography, High Pressure Liquid; Drug Contamination; Humans; Hydroxybenzoates; Male; Mass Spectrometry; Plant Bark; Plant Extracts; Prostatic Hyperplasia; Prunus africana; Sitosterols; Sulfonamides

Benign prostatic hyperplasia (BPH) is a common urological disorder of men. The ethnomedicinal use of an African plant Prunus africana (Hook.f.) Kalkman (Pygeum) in treating men's problems made it a popular remedy all over the globe for the treatment of BPH and related disorders. However, rampant collections made from the wild in Africa have pushed the plant to Appendix II of CITES demanding conservation of the species.. In the present study, the aim was to unearth the protective effect of bark of different species of Prunus against BPH. The five selected Indian plants of family Rosaceae viz. Prunus amygdalus Stokes, Prunus armeniaca L., Prunus cerasoides Buch.-Ham. ex D. Don, Prunus domestica L. and Prunus persica (L.) Batsch were evaluated against P. africana (Hook.f.) Kalkman for a suitable comparison of efficacy as antiBPH agents.. The antiBPH activity was evaluated in testosterone (2mg/kg/day, s.c, 21 days) induced BPH in Wistar rats. The parameters studied were body weights; histopathological examination, immunohistochemistry (PCNA) and biochemical estimations of the prostate; supported by prostatic index, testicular index, creatinine, testosterone levels; antioxidant and anti-inflammatory evaluation. The study also included chemical profiling using three markers (β-sitosterol, docosyl ferulate and ursolic acid) and estimation of β-sitosterol content through GC.. The Prunus species showed the presence of all the three markers in their TLC fingerprint profile and maximum amount of β-sitosterol by GC was observed in P. domestica. Interestingly, all the species exhibited significant amelioration in testosterone induced parameters with P. domestica showing the most encouraging effect as indicated from histopathological examination, immunohistochemistry and biochemical studies. The Prunus species further showed remarkable anti-inflammatory and antioxidant activity signifying their role in interfering with various possible factors involved in BPH.. These findings are suggestive of a meaningful inhibitory effect of testosterone induced BPH by the bark of different species of Prunus in the order of P. domestica, P. persica, P. amygdalus, P. cerasoides and P. armeniaca with an efficacy of P. domestica comparable to P. africana and can be used as the potential backup of Pygeum for the management of BPH.

Topics: Animals; Anti-Inflammatory Agents; Antioxidants; Biomarkers; Chromatography, Gas; Chromatography, Thin Layer; Disease Models, Animal; Inflammation Mediators; Male; Oxidative Stress; Phytotherapy; Plant Bark; Plant Extracts; Plants, Medicinal; Prostate; Prostatic Hyperplasia; Prunus armeniaca; Prunus domestica; Prunus dulcis; Prunus persica; Rats, Wistar; Sitosterols; Testosterone; Triterpenes; Urological Agents; Ursolic Acid

Phytotherapy, the use of plant based extracts (derived from fruits, seeds, roots, or bark) as medicines or health-promoting agents are often used as first-line treatments for bothersome male lower urinary tract symptoms (LUTS). Their use, either as monotherapy or in conjunction with conventional pharmaceutical treatments is becoming increasingly popular worldwide. There are now over 30 of these phytotherapeutic compounds available, with saw palmetto and pygeum being the most widely used. This paper discusses the mechanism of action, reported efficacies and potential side effects of a number of the most common phytotherapies being used for male LUTS, as well as summarizes outcome data relevant to these agents from the most current peer-reviewed publications.

Topics: Androgen Antagonists; Complementary Therapies; Flax; Humans; Hypoxis; Lower Urinary Tract Symptoms; Male; Phytotherapy; Picea; Pinus; Plant Extracts; Prostatic Hyperplasia; Prunus africana; Secale; Serenoa; Sitosterols; Urtica dioica

To study the active components and their functionary mechanism of the extract of Brassica alba seeds, which inhibits experimental mice prostatic hyperplasia.. Prostatic hyperplasia of castrated male mice induced by testosterone propionate, the penetrability of capillary vessel of mice skin induced by histamine and the endermic flesh bud of rat induced by filter paper were used as experimental models. Sinalbin and beta-sitosterol separated from seeds of Brassica alba were used to test the activities.. Sinalbin and beta-sitosterol(16.0 mg.kg-1.d-1 and 8.0 mg.kg-1.d-1) could significantly inhibit mice prostatic hyperplasia induced by testosterone propionate and activity of serum acid phosphatase(P < 0.01 or P < 0.05), Sinalbin(16.0 mg.kg-1.d-1)could significantly inhibit the hyperplasia of endermic flesh bud in rat induced by filter paper(P < 0.05), beta-sitosterol(16.0 mg.kg-1.d-1 and 8.0 mg.kg-1.d-1) could significantly decrease the penetrability of capillary vessel of mice skin induced by histamine.. Sinalbin and beta-sitosterol have anti-androgen and anti-inflammation activities.

Topics: Androgen Antagonists; Animals; Anti-Inflammatory Agents, Non-Steroidal; Capillary Permeability; Choline; Female; Male; Mice; Mustard Plant; Orchiectomy; Plants, Medicinal; Prostatic Hyperplasia; Rats; Rats, Sprague-Dawley; Seeds; Sitosterols; Testosterone Propionate

Herbal medications are used widely in the treatment of BPH. Recent studies suggest a benefit for some of these products with few side effects. The results of these studies are summarized and the possible mechanism of action of these medications are reviewed.

Topics: Humans; Hypoxis; Male; Phytotherapy; Plant Extracts; Plants, Medicinal; Prostatic Hyperplasia; Secale; Serenoa; Sitosterols; Urtica dioica

At hospital admission drugs prescribed by the general practitioner (GP) are often changed. This may have a negative impact on the relationship between family and hospital physicians as well as on the family doctor-patient-relationship. The study set out to examine the attitudes of hospital physicians towards GPs' prior ambulatory medication, especially in the case of drugs of unproven efficacy (e.g. certain drug combinations and homeopathic or herbal drugs).. A total of 129 doctors of the surgical and medical wards of the Göttingen University Hospital received a standardized questionnaire focusing on drugs prescribed by referring GPs (response rate: 65.9%). Three case vignettes were presented describing "popular" GP prescriptions. Doctors of surgical and medical departments were asked whether or not they would follow these prescriptions. Differences in the answers between the groups of doctors were tested by Fisher's exact test.. More doctors on the surgical than on the medical wards would usually follow GPs' medication (82 vs 25%; P < 0.001). According to these attitudes, more doctors of medical departments would stop the prescription of drug combination (82 vs 41%; P < 0.001); both groups would be hesitant to accept homeopathic drugs (89 vs 59%; P < 0.01) or herbal drugs (89 vs 55%; P < 0.01) as prescribed by the GP. The critical attitude especially of doctors of the medical departments towards drug combinations and herbal drugs was in line with their decision in the case vignettes (e.g. Capozide, Tebonin forte).. Especially doctors working in medical departments keep in line with conventional clinical pharmacological criteria. If they have to decide whether or not to follow patients' ambulatory medication, they may overlook GPs' decision-making process underlying their prescribing.

Topics: Aged; Attitude of Health Personnel; Captopril; Data Interpretation, Statistical; Diabetes Mellitus; Drug Combinations; Drug Prescriptions; Drug Therapy; Family Practice; Female; Flavonoids; Ginkgo biloba; Hemostatics; Humans; Hydrochlorothiazide; Hypertension; Male; Medical Staff, Hospital; Middle Aged; Plant Extracts; Prostatic Hyperplasia; Sitosterols; Surveys and Questionnaires

The measurement of prostaglandin E2 (PGE2) concentrations in the serum and prostatic fluid of healthy men, patients with prostatic hyperplasia and of patients with prostatitis was attempted and correlated to the state of disease, respectively. PGE2-concentrations with prostatic fluid of healthy men were found to be significantly lower than in patients with prostatitis. Corresponding to the course of treatment concentrations normalized, being favorably influenced by sitosterin as an adjuvant medication. Compared to healthy men, PGF2 concentrations in the prostatic fluid of patients with hyperplasia of the prostate incline to lower levels.

Topics: Adult; Chronic Disease; Dinoprostone; Follow-Up Studies; Humans; Male; Middle Aged; Prostaglandins E; Prostate; Prostatic Hyperplasia; Prostatitis; Radioimmunoassay; Sitosterols

Topics: Adult; Child; Costs and Cost Analysis; Diet; Food Analysis; Humans; Hypercholesterolemia; Infant; Male; Prostatic Hyperplasia; Sitosterols

Topics: Adult; Aged; Capsules; Double-Blind Method; Humans; Male; Middle Aged; Prostatic Hyperplasia; Prostatitis; Sitosterols

Topics: Humans; Male; Plant Extracts; Prostatic Hyperplasia; Rheology; Sitosterols; Urination Disorders; Urodynamics

Topics: Adenoma; Humans; Male; Plant Extracts; Prostatic Hyperplasia; Sitosterols; Urination Disorders; Urodynamics