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Published in: International Urology and Nephrology 3/2007

01-09-2007 | Original Paper

A prospective study of the efficacy of Serenoa repens, Tamsulosin, and Serenoa repens plus Tamsulosin treatment for patients with benign prostate hyperplasia

Authors: Fatih Hızlı, M. Cemil Uygur

Published in: International Urology and Nephrology | Issue 3/2007

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Abstract

Introduction

Increasing attention has been focused on the use of phytotherapeutic agents to alleviate the symptoms of benign prostatic hyperplasia (BPH) in recent times. The best described and studied phytotherapeutic agent is Serenoa repens (SR).

Materials and methods

This prospective study was designed to have 3 arms including SR 320 mg per day (N = 20), Tamsulosin (TAM) 0.4 mg per day (N = 20) and SR + TAM (N = 20) to reveal the superiority or equivalence between these treatment regimens in BPH.

Results

The groups were not statistically different with regard to increase in maximal urinary flow rate (Q max) and decrease in International Prostate Symptom Score (I-PSS) (P > 0.05). No adverse effect was detected in SR therapy group.

Conclusion

Treatment of BPH by both SR and TAM seems to be effective alone. None of them had superiority to another and additionally, combined therapy (SR + TAM) does not provide extra benefits. Furthermore SR is a well-tolerated agent that can be used alternatively in the treatment of LUTS due to BPH.
Literature
1.
go back to reference Holtgrewe HL (1998) Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia. Urology 51(Suppl 4A):1–7PubMedCrossRef Holtgrewe HL (1998) Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia. Urology 51(Suppl 4A):1–7PubMedCrossRef
2.
go back to reference Oesterling JE (1995) Benign prostatic hyperplasia. Medical and minimally invasive treatment options. N Engl J Med 332:99–109PubMedCrossRef Oesterling JE (1995) Benign prostatic hyperplasia. Medical and minimally invasive treatment options. N Engl J Med 332:99–109PubMedCrossRef
3.
go back to reference Buck AC (1996) Phytotheraphy for the prostate. Br J Urol 78:325–336PubMed Buck AC (1996) Phytotheraphy for the prostate. Br J Urol 78:325–336PubMed
4.
go back to reference Wilt TJ, Ishani A, Stark G et al (1998) Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 280(18):1604–1609PubMedCrossRef Wilt TJ, Ishani A, Stark G et al (1998) Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 280(18):1604–1609PubMedCrossRef
5.
go back to reference Lowe FC, Fagelman E (1999) Phytotheraphy in the treatment of benign prostatic hyperplasia: an update. Urology 53(4):671–678PubMedCrossRef Lowe FC, Fagelman E (1999) Phytotheraphy in the treatment of benign prostatic hyperplasia: an update. Urology 53(4):671–678PubMedCrossRef
6.
go back to reference Chacon A, Monga M (1999) Medical management of benign prostatic hyperplasia. Geriatr Nephrol Urol 9(1):39–48PubMedCrossRef Chacon A, Monga M (1999) Medical management of benign prostatic hyperplasia. Geriatr Nephrol Urol 9(1):39–48PubMedCrossRef
7.
go back to reference Clifford GM, Farmer RD (2000) Medical therapy for benign prostatic hyperplasia. A review of the literature. Eur Urol 38(1):2–19PubMedCrossRef Clifford GM, Farmer RD (2000) Medical therapy for benign prostatic hyperplasia. A review of the literature. Eur Urol 38(1):2–19PubMedCrossRef
8.
go back to reference Champault G, Patel JC, Bonnard AM (1984) A double-blind trial of an extract of the plant Serenoa Repens in benign prostatic hypertrophy. Br J Clin Pharmacol 18(3):461–462PubMed Champault G, Patel JC, Bonnard AM (1984) A double-blind trial of an extract of the plant Serenoa Repens in benign prostatic hypertrophy. Br J Clin Pharmacol 18(3):461–462PubMed
9.
go back to reference Tasca A, Barulli M, Cavazzana A et al (1985) Treatment of obstructive symptomatology caused by prostatic adenoma with an extract of Serenoa repens. Double-blind clinical study vs. placebo. Minerva Urol Nefrol 37(1):87–91PubMed Tasca A, Barulli M, Cavazzana A et al (1985) Treatment of obstructive symptomatology caused by prostatic adenoma with an extract of Serenoa repens. Double-blind clinical study vs. placebo. Minerva Urol Nefrol 37(1):87–91PubMed
10.
go back to reference Cukier J, Ducassou J, Le Guillou M et al (1985) Permixon versus placebo: results of a multicentre study. C R Ther Pharmacol Clin 4:15–21 Cukier J, Ducassou J, Le Guillou M et al (1985) Permixon versus placebo: results of a multicentre study. C R Ther Pharmacol Clin 4:15–21
11.
go back to reference Descotes JL, Rambeaud JJ, Deschaseaux P et al (1995) Placebo-controlled evaluation of the efficacy and tolerability of Permixon in benign prostatic hyperplasia after exclusion of placebo responders. Clin Drug Invest 9:291–297 Descotes JL, Rambeaud JJ, Deschaseaux P et al (1995) Placebo-controlled evaluation of the efficacy and tolerability of Permixon in benign prostatic hyperplasia after exclusion of placebo responders. Clin Drug Invest 9:291–297
12.
go back to reference Carraro JC, Raynaud JP, Koch G et al (1996) Comparison of phytotheraphy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1098 patients. Prostate 29(4):231–240PubMedCrossRef Carraro JC, Raynaud JP, Koch G et al (1996) Comparison of phytotheraphy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1098 patients. Prostate 29(4):231–240PubMedCrossRef
13.
go back to reference Debruyne F, Koch G, Boyle P et al (2002) for the members of the PERMAL Study Comparison of a phytotherapeutic agent (Permixon) with an α-blocker(tamsulosin) in the treatment of benign prostatic hyperplasia: a 1-year randomized international study. Eur Urol 41:497–507PubMedCrossRef Debruyne F, Koch G, Boyle P et al (2002) for the members of the PERMAL Study Comparison of a phytotherapeutic agent (Permixon) with an α-blocker(tamsulosin) in the treatment of benign prostatic hyperplasia: a 1-year randomized international study. Eur Urol 41:497–507PubMedCrossRef
14.
go back to reference Neal DE (1997) Watchful waiting or drug therapy for benign prostatic hyperplasia? Lancet 350:305–306PubMedCrossRef Neal DE (1997) Watchful waiting or drug therapy for benign prostatic hyperplasia? Lancet 350:305–306PubMedCrossRef
15.
go back to reference Boyle P, Gould AL, Roehrborn CG (1996) Prostate volume predicts outcome of treatment of benign prostatic hyperplasia with finasteride: meta-analysis of randomized clinical trials. Urology 48:398–405PubMedCrossRef Boyle P, Gould AL, Roehrborn CG (1996) Prostate volume predicts outcome of treatment of benign prostatic hyperplasia with finasteride: meta-analysis of randomized clinical trials. Urology 48:398–405PubMedCrossRef
16.
go back to reference Di Salle E, Briatico G, Giudici D et al (1994) Novel aromatase and 5 alpha-reductase inhibitors. J Steroid Biochem Mol Biol 49:289–294PubMedCrossRef Di Salle E, Briatico G, Giudici D et al (1994) Novel aromatase and 5 alpha-reductase inhibitors. J Steroid Biochem Mol Biol 49:289–294PubMedCrossRef
17.
go back to reference Di Salle E, Briatico G, Giudici D et al (1994) Endocrine properties of the testosterone 5 alpha-reductase inhibitor turosteride (FCE 26073). J Steroid Biochem Mol Biol 48:241–248PubMedCrossRef Di Salle E, Briatico G, Giudici D et al (1994) Endocrine properties of the testosterone 5 alpha-reductase inhibitor turosteride (FCE 26073). J Steroid Biochem Mol Biol 48:241–248PubMedCrossRef
18.
go back to reference Jardin A, Bensadoun H, Delauche-Cavallier MC et al (1991) Alfuzosin for treatment of benign prostatic hypertrophy. The BPH-ALF Group. Lancet 337:1457–1461PubMedCrossRef Jardin A, Bensadoun H, Delauche-Cavallier MC et al (1991) Alfuzosin for treatment of benign prostatic hypertrophy. The BPH-ALF Group. Lancet 337:1457–1461PubMedCrossRef
19.
go back to reference Abrams P (1997) Urodynamic effects of doxazosin in men with lower urinary tract symptoms and benign prostatic obstruction. Results from three double-blind placebo-controlled studies. Eur Urol 32:39–46PubMed Abrams P (1997) Urodynamic effects of doxazosin in men with lower urinary tract symptoms and benign prostatic obstruction. Results from three double-blind placebo-controlled studies. Eur Urol 32:39–46PubMed
20.
go back to reference Astin JA (1998) Why patients use alternative medicine: results of a national study. JAMA 279:1548–1553PubMedCrossRef Astin JA (1998) Why patients use alternative medicine: results of a national study. JAMA 279:1548–1553PubMedCrossRef
21.
go back to reference Vincent C, Furnham A (1996) Why do patients turn to complementary medicine? An empirical study. Br J Clin Psychol 35(Pt 1):37–48PubMed Vincent C, Furnham A (1996) Why do patients turn to complementary medicine? An empirical study. Br J Clin Psychol 35(Pt 1):37–48PubMed
22.
go back to reference Furnham A, Forey J (1994) The attitudes, behaviors and beliefs of patients of conventional vs. complementary (alternative) medicine. J Clin Psychol 50(3):458–469PubMedCrossRef Furnham A, Forey J (1994) The attitudes, behaviors and beliefs of patients of conventional vs. complementary (alternative) medicine. J Clin Psychol 50(3):458–469PubMedCrossRef
23.
go back to reference Weisser H, Tunn S, Behnke B, Krieg M (1996) Effects of the sabal serrulata extract IDS 89 and its subfractions on 5 alpha-reductase activity in human benign prostatic hyperplasia. Prostate 28(5):300–306PubMedCrossRef Weisser H, Tunn S, Behnke B, Krieg M (1996) Effects of the sabal serrulata extract IDS 89 and its subfractions on 5 alpha-reductase activity in human benign prostatic hyperplasia. Prostate 28(5):300–306PubMedCrossRef
24.
go back to reference Iehle C, Delos S, Guirou O, Tate R, Raynaud JP, Martin PM (1995) Human prostatic steroid 5 alpha-reductase isoforms – a comparative study of selective inhibitors. J Steroid Biochem Mol Biol 54(5–6):273–279PubMedCrossRef Iehle C, Delos S, Guirou O, Tate R, Raynaud JP, Martin PM (1995) Human prostatic steroid 5 alpha-reductase isoforms – a comparative study of selective inhibitors. J Steroid Biochem Mol Biol 54(5–6):273–279PubMedCrossRef
25.
go back to reference Plosker GL, Brogden RN (1996) Serenoa repens (Permixon). A review of its pharmacology and therapeutic efficacy in benign prostatic hyperplasia. Drugs Aging 9(5):379–395PubMedCrossRef Plosker GL, Brogden RN (1996) Serenoa repens (Permixon). A review of its pharmacology and therapeutic efficacy in benign prostatic hyperplasia. Drugs Aging 9(5):379–395PubMedCrossRef
26.
go back to reference Sultan C, Terraza A, Devillier C, Carilla E, Briley M, Loire C, Descomps B (1984) Inhibition of androgen metabolism and binding by a liposterolic extract of “Serenoa repens B” in human foreskin fibroblasts. J Steroid Biochem 20(1):515–519PubMedCrossRef Sultan C, Terraza A, Devillier C, Carilla E, Briley M, Loire C, Descomps B (1984) Inhibition of androgen metabolism and binding by a liposterolic extract of “Serenoa repens B” in human foreskin fibroblasts. J Steroid Biochem 20(1):515–519PubMedCrossRef
27.
go back to reference Carilla E, Briley M, Fauran F, Sultan C, Duvilliers C (1984) Binding of Permixon, a new treatment for prostatic benign hyperplasia, to the cytosolic androgen receptor in the rat prostate. J Steroid Biochem 20(1):521–523PubMedCrossRef Carilla E, Briley M, Fauran F, Sultan C, Duvilliers C (1984) Binding of Permixon, a new treatment for prostatic benign hyperplasia, to the cytosolic androgen receptor in the rat prostate. J Steroid Biochem 20(1):521–523PubMedCrossRef
28.
go back to reference Ravenna L, Di Silverio F, Russo MA, Salvatori L, Morgante E, Morrone S, Cardillo MR, Russo A, Frati L, Gulino A, Petrangeli E (1996) Effects of the lipidosterolic extract of Serenoa repens (Permixon) on human prostatic cell lines. Prostate 29(4):219–230PubMedCrossRef Ravenna L, Di Silverio F, Russo MA, Salvatori L, Morgante E, Morrone S, Cardillo MR, Russo A, Frati L, Gulino A, Petrangeli E (1996) Effects of the lipidosterolic extract of Serenoa repens (Permixon) on human prostatic cell lines. Prostate 29(4):219–230PubMedCrossRef
29.
go back to reference Paubert-Braquet M, Mencia Huerta JM, Cousse H, Braquet P (1997) Effect of the lipidic lipidosterolic extract of Serenoa repens (Permixon) on the ionophore A23187-stimulated production of leukotriene B4 (LTB4) from human polymorphonuclear neutrophils. Prostaglandins Leukot Essent Fatty Acids 57(3):299–304PubMedCrossRef Paubert-Braquet M, Mencia Huerta JM, Cousse H, Braquet P (1997) Effect of the lipidic lipidosterolic extract of Serenoa repens (Permixon) on the ionophore A23187-stimulated production of leukotriene B4 (LTB4) from human polymorphonuclear neutrophils. Prostaglandins Leukot Essent Fatty Acids 57(3):299–304PubMedCrossRef
30.
go back to reference Debruyne F, Boyle P, Calais Da Silva F, Gillenwater JG, Hamdy FC, Perrin P, Teillac P, Vela-Navarrete R, Raynaud JP, Schulman CC (2004) Evaluation of the clinical benefit of permixon and tamsulosin in severe BPH patients-PERMAL study subset analysis. Eur Urol 45(6):773–779PubMedCrossRef Debruyne F, Boyle P, Calais Da Silva F, Gillenwater JG, Hamdy FC, Perrin P, Teillac P, Vela-Navarrete R, Raynaud JP, Schulman CC (2004) Evaluation of the clinical benefit of permixon and tamsulosin in severe BPH patients-PERMAL study subset analysis. Eur Urol 45(6):773–779PubMedCrossRef
31.
go back to reference Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C (1998) Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 280(18):1604–1609PubMedCrossRef Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C (1998) Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 280(18):1604–1609PubMedCrossRef
32.
go back to reference Glemain P, Coulange C, Billebaud T, Gattegno B, Muszynski R, Loeb G (2002) Groupe de l’essai OCOS [Tamsulosin with or without Serenoa repens in benign prostatic hyperplasia: the OCOS trial]. Prog Urol 12(3):395–403 Glemain P, Coulange C, Billebaud T, Gattegno B, Muszynski R, Loeb G (2002) Groupe de l’essai OCOS [Tamsulosin with or without Serenoa repens in benign prostatic hyperplasia: the OCOS trial]. Prog Urol 12(3):395–403
33.
go back to reference Zlotta AR, Teillac P, Raynaud JP, Schulman CC (2005) Evaluation of male sexual function in patients with Lower Urinary Tract Symptoms (LUTS) associated with Benign Prostatic Hyperplasia (BPH) treated with a phytotherapeutic agent (Permixon), Tamsulosin or Finasteride. Eur Urol 48(2):269–276PubMedCrossRef Zlotta AR, Teillac P, Raynaud JP, Schulman CC (2005) Evaluation of male sexual function in patients with Lower Urinary Tract Symptoms (LUTS) associated with Benign Prostatic Hyperplasia (BPH) treated with a phytotherapeutic agent (Permixon), Tamsulosin or Finasteride. Eur Urol 48(2):269–276PubMedCrossRef
34.
go back to reference Braeckman J, Denis L, de Lavel J et al (1997) A double-blind, placebo-controlled study of the plant extract Serenoa repens in the treatment of benign hyperplasia of the prostate. Eur J Clin Res 9:247–259 Braeckman J, Denis L, de Lavel J et al (1997) A double-blind, placebo-controlled study of the plant extract Serenoa repens in the treatment of benign hyperplasia of the prostate. Eur J Clin Res 9:247–259
35.
go back to reference Carbin BE, Larsson B, Lindahl O (1990) Treatment of benign prostatic hyperplasia with phytosterols. Br J Urol 66(6):639–641PubMed Carbin BE, Larsson B, Lindahl O (1990) Treatment of benign prostatic hyperplasia with phytosterols. Br J Urol 66(6):639–641PubMed
36.
go back to reference Willetts KE, Clements MS, Champion S, Ehsman S, Eden JA (2003) Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial. BJU Int 92(3):267–270PubMedCrossRef Willetts KE, Clements MS, Champion S, Ehsman S, Eden JA (2003) Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial. BJU Int 92(3):267–270PubMedCrossRef
37.
go back to reference Gerber GS, Kuznetsov D, Johnson BC, Burstein JD (2001) Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms. Urology 58(6):960–964PubMedCrossRef Gerber GS, Kuznetsov D, Johnson BC, Burstein JD (2001) Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms. Urology 58(6):960–964PubMedCrossRef
38.
go back to reference Boyle P, Robertson C, Lowe F, Roehrborn C (2004) Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU Int 93(6):751–756PubMedCrossRef Boyle P, Robertson C, Lowe F, Roehrborn C (2004) Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU Int 93(6):751–756PubMedCrossRef
39.
go back to reference Bent S, Kane C, Shinohara K et al (2006) Saw Palmetto for benign prostatic hyperplasia. N Engl J Med 354:557–566PubMedCrossRef Bent S, Kane C, Shinohara K et al (2006) Saw Palmetto for benign prostatic hyperplasia. N Engl J Med 354:557–566PubMedCrossRef
40.
go back to reference Lepor H (1998) Long-term evaluation of tamsulosin in benign prostatic hyperplasia: placebo-controlled, double-blind extension of phase III trial. Tamsulosin Investigator Group. Urology 51(6):901–906PubMedCrossRef Lepor H (1998) Long-term evaluation of tamsulosin in benign prostatic hyperplasia: placebo-controlled, double-blind extension of phase III trial. Tamsulosin Investigator Group. Urology 51(6):901–906PubMedCrossRef
41.
go back to reference Brooks SK (1999) Effect of tamsulosin on AUA symptom score and BPH impact index as a function of symptom severity in patients with benign prostatic hyperplasia. J Urol 161(Suppl):267CrossRef Brooks SK (1999) Effect of tamsulosin on AUA symptom score and BPH impact index as a function of symptom severity in patients with benign prostatic hyperplasia. J Urol 161(Suppl):267CrossRef
42.
go back to reference Schulman CC, Cortvriend J, Jonas U, Lock TM, Vaage S, Speakman MJ (1999) Tamsulosin: 3-year long-term efficacy and safety in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction: analysis of a European, multinational, multicenter, open-label study European Tamsulosin Study Group. Eur Urol 36(6):609–620PubMedCrossRef Schulman CC, Cortvriend J, Jonas U, Lock TM, Vaage S, Speakman MJ (1999) Tamsulosin: 3-year long-term efficacy and safety in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction: analysis of a European, multinational, multicenter, open-label study European Tamsulosin Study Group. Eur Urol 36(6):609–620PubMedCrossRef
43.
go back to reference Giannakopoulos X, Baltogiannis D, Giannakis D et al (2002) The lipidosterolic extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a comparison of two dosage regimens. Adv Ther 19(6):285–296PubMed Giannakopoulos X, Baltogiannis D, Giannakis D et al (2002) The lipidosterolic extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a comparison of two dosage regimens. Adv Ther 19(6):285–296PubMed
44.
go back to reference Braeckman J (1994) The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study. Curr Ther Res 55:776–785CrossRef Braeckman J (1994) The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study. Curr Ther Res 55:776–785CrossRef
45.
go back to reference Gerber GS, Zagaja GP, Bales GT, Chodak GW, Contreras BA (1998) Saw palmetto (Serenoa repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Urology 51(6):1003–1007PubMedCrossRef Gerber GS, Zagaja GP, Bales GT, Chodak GW, Contreras BA (1998) Saw palmetto (Serenoa repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Urology 51(6):1003–1007PubMedCrossRef
46.
go back to reference Wang LG, Liu XM, Kreis W, Budman DR (1997) Down-regulation of prostate-specific antigen expression by finasteride through inhibition of complex formation between androgen receptor and steroid receptor-binding consensus in the promoter of the PSA gene in LNCaP cells. Cancer Res 57(4):714–719PubMed Wang LG, Liu XM, Kreis W, Budman DR (1997) Down-regulation of prostate-specific antigen expression by finasteride through inhibition of complex formation between androgen receptor and steroid receptor-binding consensus in the promoter of the PSA gene in LNCaP cells. Cancer Res 57(4):714–719PubMed
47.
go back to reference Romics I, Schmitz H, Frang D (1993) Experience in treating benign prostatic hypertrophy with Sabal serrulata for one year. Int Urol Nephrol 25(6):565–569PubMed Romics I, Schmitz H, Frang D (1993) Experience in treating benign prostatic hypertrophy with Sabal serrulata for one year. Int Urol Nephrol 25(6):565–569PubMed
48.
go back to reference Kondas J, Philipp V, Dioszeghy G (1996) Sabal serrulata extract (Strogen forte) in the treatment of symptomatic benign prostatic hyperplasia. Int Urol Nephrol 28(6):767–772PubMedCrossRef Kondas J, Philipp V, Dioszeghy G (1996) Sabal serrulata extract (Strogen forte) in the treatment of symptomatic benign prostatic hyperplasia. Int Urol Nephrol 28(6):767–772PubMedCrossRef
49.
go back to reference Roveda S, Colombo P (1994) Sperimentazione clinica controllata sulla bioequivalenza terapeutica e sulla tollerabilita dei prodotti a base di Serenoa repens in capsule da 160 mg o capsule rettali da 640 mg. Arch Med Intern 46:61–75 Roveda S, Colombo P (1994) Sperimentazione clinica controllata sulla bioequivalenza terapeutica e sulla tollerabilita dei prodotti a base di Serenoa repens in capsule da 160 mg o capsule rettali da 640 mg. Arch Med Intern 46:61–75
50.
go back to reference Drew A (2000) An alternative stream: Serenoa repens for benign prostatic hypertrophy? Aust Prescr 23:79 Drew A (2000) An alternative stream: Serenoa repens for benign prostatic hypertrophy? Aust Prescr 23:79
51.
go back to reference Hamid S, Rojter S, Vierling J (1997) Protracted cholestatic hepatitis after the use of prostata. Ann Intern Med 127(2):169–170PubMed Hamid S, Rojter S, Vierling J (1997) Protracted cholestatic hepatitis after the use of prostata. Ann Intern Med 127(2):169–170PubMed
Metadata
Title
A prospective study of the efficacy of Serenoa repens, Tamsulosin, and Serenoa repens plus Tamsulosin treatment for patients with benign prostate hyperplasia
Authors
Fatih Hızlı
M. Cemil Uygur
Publication date
01-09-2007
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 3/2007
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-006-9106-5

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