title: Observational database serenoa repens (DOSSER): overview, analysis and results. A multicentric SIUrO (Italian Society of Oncological Urology) project.
abstract: OBJECTIVE
  Men affected with Benign Prostate Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS) are demonstrating to require an increasing amount of attention from Urologists and Primary-care Physicians. Over the years, common urological medications were based on either alpha-blockers and/or 5alpha-reductase inhibitors. During the last decade the phytotherapeutic drugs are gaining a more often central role in the BPH and LUTS managements. In particular, clinical usage of the extract of the dried ripe fruit of serenoa repens with a dosage of 320 mg per day, has shown its clinical efficacy and its superiority. Purpose of this multicentric observational retrospective study was to evaluate all the urological aspects (clinical, biochemical, instrumental and pathological) of patients affected by BPH and LUTS, with a PSA < 10 ng/ml, a previous negative prostatic biopsy and in therapy with a daily dose of 320/640 mg of serenoa repens.
  
  
  METHODS
  The study was conducted in 8 different centers throughout Italy from September 2010 to November 2011. Data and information of 298 men with an average of 63 years (mean PSA of 5.4 ng/ml and mean prostate gland volume of 57 cc), affected by non-acute urinary symptoms caused by BPH, a dosed PSA level inferior to 10 ng/ml, a previous negative prostate biopsy and in therapy with serenoa repens alone or associated to an alpha-blocker, were retrospectively inserted in an extensive on-line SIUrO Database. Comprehensive questionnaires were filled in for each patient at 3 and 6 months of follow-up. Each questionnaire contained various sections, each of them composed by several items: dosed PSA levels, uroflowmetry, International Prostate Symptoms Score (IPSS), International Index of Erectile Function (IIEF-5), trans-rectal ultrasound (TRUS) patterns, digital rectal examinations (DRE) aspects, previous prostate bioptical results (histology) and side effects.
  
  
  RESULTS
  PSA levels weren't subjected to an increase, revealing a stabilizing or downward trend. Percentage of patients with PSA below the level of 4 ng/mL was lower at the end of the study. The overall changes in the uroflowmetry were similar and parallel both in the group with only serenoa repens intake and in the group with serenoa repens plus alpha-blocker. The mean medium flow and the mean maximum flow had a slightly increase along the observation time. There was a substantial decreasing in the amount of patients presenting severe prostatic symptoms. Patients reported through the IIEF-5 score a sexual activity substantially unchanged after 6 months of follow-up. The serenoa repens intake resulted in an improvement of the "inflammatory-like reports", in terms of ultrasound patterns, DRE and bioptical features.
  
  
  CONCLUSIONS
  serenoa repens demonstrated its efficacy reducing dysuria with minimal side effects. Further prospective studies might confirm its stabilization or lowering role on PSA levels in this cohort of patients and its possible clinical anti-inflammatory action.
authors.affiliation: Clinica Urologica, Policlinico Sant'Orsola-Malpighi, Università di Bologna, Italy. Alessandro.Bertaccini@gmail.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bertaccini
authors.forename: Marco
authors.initials: M
authors.lastname: Giampaoli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cividini
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Gattoni
authors.forename: Roberto
authors.initials: R
authors.lastname: Sanseverino
authors.forename: Tommaso
authors.initials: T
authors.lastname: Realfonso
authors.forename: Giorgio
authors.initials: G
authors.lastname: Napodano
authors.forename: Andrea
authors.initials: A
authors.lastname: Fandella
authors.forename: Elisa
authors.initials: E
authors.lastname: Guidoni
authors.forename: Domenico
authors.initials: D
authors.lastname: Prezioso
authors.forename: Raffaele
authors.initials: R
authors.lastname: Galasso
authors.forename: Carmine
authors.initials: C
authors.lastname: Cicalese
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scattoni
authors.forename: Angelo
authors.initials: A
authors.lastname: Armenio
authors.forename: Giario
authors.initials: G
authors.lastname: Conti
authors.forename: Matteo
authors.initials: M
authors.lastname: Corinti
authors.forename: Roberta
authors.initials: R
authors.lastname: Spasciani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Liguori
authors.forename: Nikolitsa
authors.initials: N
authors.lastname: Lampropoulou
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martorana
mesh_terms: D016208:Databases, Factual; D005638:Fruit; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D012189:Retrospective Studies; D028024:Serenoa
chemical_list: D010936:Plant Extracts