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The prostate is a variable-sized gland located in the male pelvis, usually the size of a walnut measuring 3-4 centimeters long by 3-5 centimeters in width. On average the gland weighs about 20 grams. It is found behind the pubic bone, in front of the rectum, and below the bladder, surrounded by the pelvic muscles. The prostate surrounds the urethra which carries urinefrom the bladder to the penis and travels in the center of the gland. The seminal vesicles attach to the prostate and produce material that mixes with prostatic fluid to form semen. The tubes from the testicles carry sperm to the prostate where the sperm are mixed with the prostate and seminal vesicle fluid. This fluid is then ejaculated during orgasm by a connection to the urethra called the ejaculatory ducts.
For many years the prostate was thought to exist in "lobes", however, we now refer to the prostate as having various concentric zones. These zones are termed: anterior fibromuscular stroma, peripheral zone, central zone, and transition zone. It is the peripheral zone of the prostate that a doctor can feel by a finger in the rectum. Almost all prostate cancers start in the peripheral zone, thus, the importance of the rectal examination. The transition zone generally accounts for less than 5% of the total prostate volume. Nonetheless, it is the exclusive site for the
development of benign prostatic hyperplasia (BPH) and may therefore become massive. The central zone is involved with the connection of the seminal vesicles to the prostate and is rarely associated with any disease process. The anterior fibromuscular stroma is the anchoring point of the urethral sphincter that controls urination: it does not have any glands and therefore cancer or enlargement does not develop here. The following are commonly used naturopathic treatment for the symptoms of BPH.
Saw Palmetto
Also known as Seronea Repens
It is derived from berries
160mg twice a day
minimal side effects
supposedly will increase urine flow
Pygeum Africanun
derived from African evergreen tree
not as effective as Saw Palmetto with high
degree of stomach symptoms
Stinging Nettles
in Europe marketed under name Bazoton-r
shows marked decrease in residual urine volume
Cernilton-r
popular in Sweden
used to treat prostatitis
What is common in all the plant extract therapies for Benign Enlargement of the Prostate Gland?
All contain a chemical with a steriod like preparations that exert a mild hormonal effect. The speculation that these agents exert an anti-androgenic or anti-estrogenic effect is conflicting.
STANDARDIZATION AND LONGER, BETTER CONTROLLED STUDIES HAVE INDICATED:
--evidence for efficacy of the phyto therapies is inconclusive and cannot be recommended.
--testimonials of men who have taken phytotherapy agents do not stand against the rigorous scientific inquiry.
--At the present time the best advice is CAVEAT
EMPTOR, let the buyer beware.
Phytotherapy the use of plants or plant extracts for medicinal uses, has been described since ancient times. Use of plant extracts for the treatment of symptoms associated with benign prostatic hypertrophy (BPH) was described on Egyptian papyrus in the 15thCentury B.C.. Thc use of plant extracts enjoys wide application in Europe.
Phytopharmaceutical agents are frequently prescribed for the treatment of prostatism in Italy, Germany and France. Usage in the United States is not as widespread; however, it is increasing rapidly. "Health food" stores are the major distributors of medicinal botanicals in the United States.
The medical management of BPH with agents other than hormones or alpha- bIockers continues to be of interest. The possibility that an agent with a natural ingredient and low side effects might be of value to patients is an attractive one.
These agents must be subjected to the same highly critical evaluation which the hormones and alpha~blockers have experienced. Despite being available in Europe for centuries, most of these compounds have undergone little or no final
testing to determine efficacy. Several agents have undergone limited short-term placebo controlled trials: the most widely studied extract has been saw palmetto berry.
The medical treatment of BPH with agents other than hormones or alpha blockers has traditionally been
divided into five groups:
1. Phytotherapeutic Agents
2. Cholesterol-lowering agents
3. Amino-acid complexes
4. Organ extracts
5. Minerals (Zinc)
The delineation between these groups has become blurred and there is considerable cross- over between groups I and 2 and especially since many "prostate pills" contain several different ingredients from the several classes. Three recent review articles critically examine the use of plant extract therapy in use with symptomatic BPH.
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