Complementary and alternative medicine (CAM) includes various practices, measures and products which are not presently considered as part of the conventional (mainstream) medicine. Herbal products, vitamins, minerals and amino acids are increasingly popular as dietary supplements for the treatment, improvement and prophylaxis of urological diseases, and as therapeutic options to improve general health and well-being.
As these products are available for free without prescription, conventional healthcare providers are often unaware that their patients are using CAM. A particular attention is paid to herbal products by the public. For this reason it is essential to know that some herbal supplements may act in the same way as chemical drugs, and that the fact that they originate ‘from nature’ does not mean that they are safe and/or with no potential harmful effects and/or toxicity. The possible interactions with conventional medications and contamination with prescription drugs and metals have been reported. The active components of many phytotherapeutic preparations and their mechanism(s) of action are still being determined and evaluated. There is scientific evidence for the effectiveness of some treatments, but for most of them, many important key questions still need to be answered through basic research and well-designed studies, according to established guidelines. Because of the increasing popularity and use of Phytotherapy, urologists should not ignore it, and be well informed about its benefits and potential risks.
World Health Organization,WHO monographs on Selected Medicinal Plants, Volume 1, 2 - 2002/2003 - Geneva (Switzerland).
2.
ESCOP monographs on the medicinal uses of plant drugs (2002) - European Scientific Cooperative on Phytotherapy.
3.
WangL., Del PrioreL.V.. Bull's-eye maculopathy secondary to herbal toxicity from uva ursi.Am J Ophthalmol2004; 137: 1135–7.
4.
BlumenthalM., BusseW.R., KleinS. eds. (1998). The complete German Commission E monographs.Austin, TX, American Botanical Council.
5.
MarxH., BüchmannR.. Über harntreibende Heilpflanzen.Dtsch Med Wochenschr1937; 63: 384–6.
6.
EngesserA., BerschU., BerchtoldJ., GöckingK., SchaffnerW.. Birkenblättertee (Betulae folium) gegen Infekte der unteren Harnwegw - eine Pilotstudie.Arch Pharm Pharm Med Chem1998; 331(Suppl 1): V33.
7.
FooL.Y., LuY., HowellA.B., VorsaN.. The structure of cranberry proanthocyanidins which inhibit adherence of uropathogenic P-fimbriated Escherichia coli in vitro.Phytochemistry2000; 54: 173–181.
8.
AhujaS., KaackB., RobertsJ.. Loss of fimbrial adhesion with the addition of Vaccinium macrocarpon to the growth medium of P-fimbriated Escherichia coli.J Urol1998; 159: 559–562.
9.
GrantP.. Warfarin and cranberry juice: an interaction?J Heart Valve Dis2004; 13: 25–6.
10.
Committee on Safety on Medicines.Possible interaction between warfarin and cranberry juice.Curr Probl Pharmacovig2003; 29: 8.
11.
Committee on Safety on Medicines.Interaction between warfarin and cranberry juice: new advice.Curr Probl Pharmacovig2004; 14: 2.
12.
KontiokariT., SundqvistK., NuutinenM., PokkaT., KoskelaM., UhariM.. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women.BMJ2001; 322(7302): 1571.
13.
StothersL.. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women.Can J Urol2002; 9(3): 1558–62.
14.
McMurdoM.E., BissetL.Y., PriceR.J., PhillipsG., CrombieI.K.. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial.Age Ageing2005; 34(3): 256–61.
ChanJ.M., GannP.H., GiovannucciE.L.. Role of diet in prostate cancer development and progression.J Clin Oncol2005; 23(32): 8152–60.
18.
CasarosaC., Cosci di CoscioM., FrattaM.. Lack of effect of a liposterolic extract of Serenoa repens on plasma levels of testosterone, follicle-stimulating hormone and luteinizing hormone.Clin Ther.1988; 10(5): 585–8.
19.
VacherP., PrevarskayaN., SkrymaR.The lipidosterolic extract from Serenoa repens interferes with prolactin receptor signal transduction.J. Biomed. Sci.1995 Oct; 2(4): 357–365.
20.
Di SilverioF., MontiS., SciarraA.Effects of long term treatment with Serenoa repens (Permixon) on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia.Prostate1998 Oct 1; 37(2): 77–83.
21.
WiltT., IshaniA., StarkG., MacDonaldR., MulrowC., LauJ.. Serenoa repens for benign prostatic hyperplasia. In: The Cochrane Library, Issue 2, 2005. Oxford: Update software. Search date 2002; primary sources Medline, Embase, Phytodok, and the Cochrane Library.
22.
DebruyneF., KochG., BoyleP.Comparison of a phytotherapeutic agent (Permixon) with an alpha-blocker (tamsulosina) in the treatment of benign prostatic hyperplasia: a 1-year randomized international study.Eur Urol.2002; 41(5): 497–507.
23.
BoyleP.. Robertson C, Lowe F, Roehrborn C. Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia.BJU Int.2004; 93(6): 751–6.
24.
ChrubasikJ.E., RoufogalisB.D., WagnerH., ChrubasikS.. A comprehensive review on the stinging nettle effect and efficacy profiles. Part II: Urticae radix.Phyromedicine2007; 14: 568–579.
25.
SchneiderT., RübbenH.. Extract of stinging nettle roots (Bazoton®-uno) in long-term treatment of benign prostatic syndrome (BPS). Results of a randomized, double-blind, placebo-controlled multicenter study after 12 month.Urologe[A]2004; 43: 302–6.
26.
SökelandJ.. Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome.BJU Int2000; 86(4): 439–442.
27.
EdgarA.D., LevinR., ConstantinouC.E., DenisL.. A critical review of the pharmacology of the plant extract of Pygeum africanum in the treatment of LUTS.Neurourol Urodyn2007; 26(4): 458–63.
28.
BrezaJ., DzurnyO., BorowkaA.Efficacy and acceptability of tadenan (Pygeum africanum extract) in the treatment of benign prostatic hyperplasia (BPH): a multicentre trial in Central Europe.Curr Med Res Opin1998; 14: 127–39.
29.
KrzeskiT., KazònM., BorkowskiA., WiteskaA., KuczeraJ.. Combined extracts of Urtica dioica and Pygeum africanum in the treatment of benign prostatic hyperplasia: double blind comparison of two doses.Clin. Ther.1993 Nov-Dec; 15(6): 1011–1020.
BachD.. Placebokontrollierte Langzeittherapiesstudie mit Kürbissamen-extrakt bei BPH-bedingten Miktionsbeschwerden.Urologe B2000; 40: 437–43.
32.
BachD., SchmittM., EbelingL.. Phytopharmaceutical and synthetic agents in the treatment of benign prostatic hyperplasia.Phytomedicine1997; 3: 309–313.
33.
KobayashiY., SugayaY., TokueA.. Clinical effects of beta-sitosterol (phytosterol) on benign prostatic hyperplasia: preliminary study.Hinyokika Kiyo1998; 44(12): 865–868.
34.
KlippelK.F., HiltlD.M., SchippB.. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. German BPH-Phyto Study group.Br. J. Urol.1997; 80(3): 427–432.
35.
WiltT.J., MacdonaldR., IshaniA.. Beta sitosterol for the treatment of benign prostatic hyperplasia: a systematic review.BJU Int1999; 83: 976–983.
36.
ChenJ., WollmanY., ChernichovskyT., IainaA., SoferM., MatzkinH.. 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 Int1999; 83(3): 269–73.
37.
KimJ.Y., LeeH.J., KimJ.S., RyuJ.H.. Induction of nitric oxide synthase of saponins of heat-processed ginseng.Biosci Biotechnol Biochem2005; 69(5): 891–5.
38.
RyuJ.K., LeeT., KimD.J.Free radical-scavenging activity of Korean red ginseng for erectile dysfunction in non-insulin-dependent diabetes mellitus rats.Urology2005; 65(3): 611–5.
39.
KangK.S., YokozawaT., KimH.Y., ParkJ.H.. Study on the nitric oxide scavenging effects of ginseng and its compounds.J Agric Food Chem2006; 54(7): 2558–62.
ChoiH.K., SeongD.H., RhaK.H.. Clinical efficacy of Korean red ginseng for erectile dysfunction.Int J Impot Res1995; 7(3): 181–6.
42.
HongB., JiY.H., HongJ.H., NamK.Y., AhnT.Y.. A double–blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction: a preliminary report.J Urol2002; 168(5): 2070–3.
43.
ZhengB.L., KimC.H., RogersL.Effect of a Lipidic Extract from Lepidium meyenii on sexual behaviour in mice and rats.Urology2000; 55: 598–602.
44.
CórdovaA., VegaK., VillenaA., & GonzalesG.F.. Efecto del Lepidium meyenii (Maca) una planta alto-andina sobre el estado de ánimo y el deseo sexual en varones aparentemente normales.Reprodução e Climatério2001 (Suppl); 16: 96–97.
45.
GonzalesG.F., CórdovaA., VegaK., ChungA., VillenaA., GóñezC.. Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men.J Endocrinol2003; 176(1): 163–8.
46.
JohnsonS.. Iazzetta J, Dewar C. Severe Raynaud's phenomenon with yohimbine therapy for erectile dysfunction.J Rheumatol2003; 30(11): 2503–5.
47.
ErnstE., PittlerM.H.. Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials.J Urol1998; 159: 433–436.
