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Article

Impact of the Treatment of Serenoa repens, Solanum lycopersicum, Lycopene and Bromelain in Combination with Alfuzosin for Benign Prostatic Hyperplasia. Results from a Match-Paired Comparison Analysis

by
Luca Lambertini
1,2,
Fabrizio Di Maida
1,2,
Riccardo Tellini
1,2,
Claudio Bisegna
1,2,
Francesca Valastro
1,2,
Antonio Andrea Grosso
1,2,
Sabino Scelzi
1,2,
Francesco Del Giudice
3,
Matteo Ferro
4,
Giacomo Maria Pirola
5,
Marilena Gubbiotti
5,
Lorenzo Masieri
1,2,
Gian Maria Busetto
3,
Ottavio de Cobelli
4,
Andrea Minervini
1,2 and
Andrea Mari
1,2,*
1
Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, Careggi Hospital, 50134 Florence, Italy
2
Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
3
Department of Urology, Sapienza University of Rome, 00185 Rome, Italy
4
Division of Urology, European Institute of Oncology, IRCCS, 20133 Milan, Italy
5
Department of Urology, San Donato Hospital, 52100 Arezzo, Italy
*
Author to whom correspondence should be addressed.
Uro 2021, 1(4), 228-237; https://doi.org/10.3390/uro1040025
Submission received: 13 October 2021 / Revised: 3 November 2021 / Accepted: 10 November 2021 / Published: 12 November 2021
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Abstract

Background: Phytotherapeutic agents aroused an increasing interest either as alternative or in addition to conventional therapy in the management of BPH. The aim of the article was to evaluate the clinical and functional changes after add-on treatment with Serenoa repens associated with Solanum lycopersicum, lycopene and bromelain in patients with BPH presenting with mild to moderate LUTS and previously treated only with Alfuzosin over a 6–12 months period. Materials and methods: Between January and July 2019, patients with symptomatic BPH already on treatment with Alfuzosin (Al) 10 mg for at least 6–12-month were enrolled at three academic referral centres, included in a prospective treatment group, and managed with a combination treatment of Al and 6-month daily oral single-tablet supplementation of Serenoa repens and Solanum lycopersicum + lycopene + bromelain (SeR + SL + Ly + Br). A retrospective control group with comparable baseline characteristics was obtained by performing a propensity score matching from a database of 434 patients managed with Alfuzosin 10 mg/day only over a 6–12 months period between March 2015 and December 2018. IPSS, QoL questionnaires, voiding diary assessment, postvoid residual volume (PVR), maximal (Qmax) and average (Qave) urinary flow rates were evaluated at baseline in the treatment group at the moment of patient accrual, in the control group after 6-month of treatment with alfuzosin, and thereafter at 3 and 6 months in both groups. Results: Overall, 250 patients entered the study (n = 125 treatment group; n = 125 control group). Total IPSS score significantly decreased at 6-month assessment from baseline in the treatment vs control group (17 [IQR: 12–20] vs 12 [IQR: 9–14], p = 0.02) with a significative storage symptoms improvement detected both at 3- (p = 0.03) and 6-month evaluation (p = 0.001). PVR significantly improved at each follow-up visit with the most relevant reduction at 6-month assessment (125 cc vs. 102 cc; p = 0.02). Moreover, a significative improvement in LUTS-related quality of life (QoL) was recorded at 3- and 6-month assessment with a median decrease of −1 and −2 (p = 0.05 and p = 0.001 respectively) from baseline. Conclusions: Combination treatment with AB and SeR + SL + Ly + Br led to meaningful improvements in LUTS severity compared to AB as monotherapy, after a 6-month treatment period in men with mild to moderate LUTS/BPH.
Keywords: benign prostate hyperplasia; inflammation; phytotherapy; Serenoa repens; Solanum lycopersicum; lycopene; bromelain; α1 blockers benign prostate hyperplasia; inflammation; phytotherapy; Serenoa repens; Solanum lycopersicum; lycopene; bromelain; α1 blockers

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MDPI and ACS Style

Lambertini, L.; Di Maida, F.; Tellini, R.; Bisegna, C.; Valastro, F.; Grosso, A.A.; Scelzi, S.; Del Giudice, F.; Ferro, M.; Pirola, G.M.; et al. Impact of the Treatment of Serenoa repens, Solanum lycopersicum, Lycopene and Bromelain in Combination with Alfuzosin for Benign Prostatic Hyperplasia. Results from a Match-Paired Comparison Analysis. Uro 2021, 1, 228-237. https://doi.org/10.3390/uro1040025

AMA Style

Lambertini L, Di Maida F, Tellini R, Bisegna C, Valastro F, Grosso AA, Scelzi S, Del Giudice F, Ferro M, Pirola GM, et al. Impact of the Treatment of Serenoa repens, Solanum lycopersicum, Lycopene and Bromelain in Combination with Alfuzosin for Benign Prostatic Hyperplasia. Results from a Match-Paired Comparison Analysis. Uro. 2021; 1(4):228-237. https://doi.org/10.3390/uro1040025

Chicago/Turabian Style

Lambertini, Luca, Fabrizio Di Maida, Riccardo Tellini, Claudio Bisegna, Francesca Valastro, Antonio Andrea Grosso, Sabino Scelzi, Francesco Del Giudice, Matteo Ferro, Giacomo Maria Pirola, and et al. 2021. "Impact of the Treatment of Serenoa repens, Solanum lycopersicum, Lycopene and Bromelain in Combination with Alfuzosin for Benign Prostatic Hyperplasia. Results from a Match-Paired Comparison Analysis" Uro 1, no. 4: 228-237. https://doi.org/10.3390/uro1040025

APA Style

Lambertini, L., Di Maida, F., Tellini, R., Bisegna, C., Valastro, F., Grosso, A. A., Scelzi, S., Del Giudice, F., Ferro, M., Pirola, G. M., Gubbiotti, M., Masieri, L., Busetto, G. M., de Cobelli, O., Minervini, A., & Mari, A. (2021). Impact of the Treatment of Serenoa repens, Solanum lycopersicum, Lycopene and Bromelain in Combination with Alfuzosin for Benign Prostatic Hyperplasia. Results from a Match-Paired Comparison Analysis. Uro, 1(4), 228-237. https://doi.org/10.3390/uro1040025

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