The effect of phytosterols on quality of life in the treatment of benign prostatic hyperplasia.
In the United States, phytosterols are available as over-the-counter dietary supplements and are promoted as a safe and natural way to maintain a healthy prostate. In men with benign prostatic hyperplasia (BPH), evidence suggests that the agents improve urologic symptoms and flow measures to a greater extent than placebo and to a similar extent as finasteride. The primary goal for treating men with BPH is to reduce lower urinary tract symptoms and increase quality of life (QOL). Therefore, QOL has become an increasingly important end point in clinical trials. We reviewed all seven studies that determined the effect of phytosterols on QOL in patients with BPH. All trials assessed QOL with international prostate symptom score questions. Six studies found phytosterols to have beneficial effects on QOL; however, poor study design limits what can be learned from these evaluations. Most studies included a limited number of patients, and many were not placebo controlled. Since few of them evaluated the effect of phytosterols beyond 6 months, little evidence exists of the agents' long-term efficacy in reducing symptomatology or increasing QOL. Finally, phytosterols have not been adequately compared with alpha-blocking agents, one of the most widely administered and effective pharmacologic treatments of BPH. Larger studies comparing phytosterols with other treatments of BPH such as alpha-blockers should be conducted. In addition, a consensus should be reached as to which questionnaires are best to evaluate potential changes in QOL after treatment of BPH.
Coleman
Craig I
CI
Hartford Hospital, Connecticut, USA.
Hebert
John H
JH
Reddy
Prabashni
P
D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010840:Phytosterols / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*
D010840:Phytosterols