madman
Super Moderator
Abstract
Background: Benign prostatic hyperplasia (BPH) is very common in aging men. We aimed to compare the effects of tamsulosin and pumpkin (Cucurbita pepo) seed oil on BPH symptoms.
Methods: This single-blind randomized clinical trial included patients with BPH aged≥50 years referred to the Urology Clinic of Shahid Beheshti Hospital, Hamadan, Iran, from August 23, 2019, to February 19, 2020. Patients were randomized into two groups. One group received 0.4 mg tamsulosin every night at bedtime and the other received 360 mg pumpkin seed oil twice a day. Patients’ age, weight, height, and body mass index (BMI) were recorded. The International Prostate Symptom Score (IPSS) was filled out by the patients at baseline and then 1 month and 3 months after the initiation of treatment. The BPH-associated quality of life (QoL), serum prostate-specific antigen, prostate, and postvoid residual volume, and maximum urine flow were also assessed at baseline and 3 months later. Drug side effects were also noted.
Results: Of the 73 patients included in this study with a mean age of 63.59±7.04 years, 34 were in the tamsulosin group and 39 were in the pumpkin seed oil group. Patients were comparable with respect to age, weight, height, BMI, and baseline principal variables in both groups. Also, there was no significant difference between groups in terms of principal variables at any time point. However, there was a significant decrease in IPSS and a significant improvement in QoL in both groups. Although the decrease in IPSS from baseline to 1 month and 3 months were significantly higher in the tamsulosin group compared to the pumpkin group (P=0.048 and P=0.020, respectively), the decrease in IPSS from 1 to 3 months was similar (P=0.728). None of the patients in the pumpkin group experienced drug side effects, while dizziness (5.9%), headache (2.9%), retrograde ejaculation (2.9%), and erythema with pruritus occurred in the tamsulosin group.
Conclusions: Pumpkin (Cucurbita pepo) seed oil relieved BPH symptoms with no side effects, but was not as effective as tamsulosin. Further studies are required to confirm the role of pumpkin seed oil as an option for the treatment of BPH symptoms.
Introduction
Benign prostatic hyperplasia (BPH) is a common age-dependent chronic disease that results from the progressive enlargement of the prostate gland due to the non-malignant proliferation of epithelial prostate cells and smooth muscle cells [1]. A recent systematic review and meta-analysis including data from 25 countries reported a lifetime prevalence of 26.2% for BPH [2]. Patients with BPH become symptomatic when the tissue overgrowth around the urethra constricts its opening leading to lower urinary tract symptoms (LUTS), including incomplete urination, frequency, urgency, nocturia, and decreased urine flow [3]. The prevalence of BPH-associated LUTS increases with age and it has been reported that approximately 80% of men experience BPH-associated LUTS by 70 years of age [4]. However, not every man with BPH symptoms seeks medical attention; most often, BPH patients only seek medical care when BPH-associated LUTS become bothersome or intolerable [1].
There is a variety of treatment strategies for BPH symptoms depending on symptom severity, together with patient discomfort and preference. These treatment strategies include lifestyle alterations, medical therapy, and surgical treatment [5]. Alpha-blockers such as tamsulosin are excellent first-line options of medical therapy [6]. Recently, there has been an increasing tendency towards the use of herbal medicines for different medical conditions. Pumpkin (Cucurbita) seeds are traditionally known around the world for their remedial effects on urinary tract complications, such as nocturia, urinary frequency, and stress urinary incontinence [7]. Pumpkins belong to the Cucurbitaceae family which includes various species such as Cucurbita pepo, Cucurbita moschata, and Cucurbita maxima [8]. Cucurbita pepo seed oil consists of high amounts of free fatty acids serving as a natural source of vitamins, proteins, trace elements, and polyunsaturated fatty acids, such as omega 3, 6, and 9 [9]. It is the phytosterol content of Cucurbita pepo seed oil that appears to interfere with the function of dihydrotestosterone produced by 5α-reductase which plays a major role in the process of BPH [10]. The phytosterol content varies among different Cucurbita species, including Cucurbita pepo and the previously mentioned Cucurbita moschata and Cucurbita maxima [11, 12]. However, only Cucurbita pepo is available in the Iranian market. Thus, in the current study, we aimed to compare the effects of Cucurbita pepo with tamsulosin for the treatment of BPH symptoms.
Conclusions
Both pumpkin seed oil and tamsulosin significantly reduced BPH symptoms; however, due to the higher reduction in IPSS scores from baseline to 1 month and 3 months, tamsulosin was more effective. The advantage of pumpkin seed was its lower side effects of pumpkin seeds. Further studies are required to confirm the role of pumpkin seed oil as an option for the treatment of BPH symptoms.
Background: Benign prostatic hyperplasia (BPH) is very common in aging men. We aimed to compare the effects of tamsulosin and pumpkin (Cucurbita pepo) seed oil on BPH symptoms.
Methods: This single-blind randomized clinical trial included patients with BPH aged≥50 years referred to the Urology Clinic of Shahid Beheshti Hospital, Hamadan, Iran, from August 23, 2019, to February 19, 2020. Patients were randomized into two groups. One group received 0.4 mg tamsulosin every night at bedtime and the other received 360 mg pumpkin seed oil twice a day. Patients’ age, weight, height, and body mass index (BMI) were recorded. The International Prostate Symptom Score (IPSS) was filled out by the patients at baseline and then 1 month and 3 months after the initiation of treatment. The BPH-associated quality of life (QoL), serum prostate-specific antigen, prostate, and postvoid residual volume, and maximum urine flow were also assessed at baseline and 3 months later. Drug side effects were also noted.
Results: Of the 73 patients included in this study with a mean age of 63.59±7.04 years, 34 were in the tamsulosin group and 39 were in the pumpkin seed oil group. Patients were comparable with respect to age, weight, height, BMI, and baseline principal variables in both groups. Also, there was no significant difference between groups in terms of principal variables at any time point. However, there was a significant decrease in IPSS and a significant improvement in QoL in both groups. Although the decrease in IPSS from baseline to 1 month and 3 months were significantly higher in the tamsulosin group compared to the pumpkin group (P=0.048 and P=0.020, respectively), the decrease in IPSS from 1 to 3 months was similar (P=0.728). None of the patients in the pumpkin group experienced drug side effects, while dizziness (5.9%), headache (2.9%), retrograde ejaculation (2.9%), and erythema with pruritus occurred in the tamsulosin group.
Conclusions: Pumpkin (Cucurbita pepo) seed oil relieved BPH symptoms with no side effects, but was not as effective as tamsulosin. Further studies are required to confirm the role of pumpkin seed oil as an option for the treatment of BPH symptoms.
Introduction
Benign prostatic hyperplasia (BPH) is a common age-dependent chronic disease that results from the progressive enlargement of the prostate gland due to the non-malignant proliferation of epithelial prostate cells and smooth muscle cells [1]. A recent systematic review and meta-analysis including data from 25 countries reported a lifetime prevalence of 26.2% for BPH [2]. Patients with BPH become symptomatic when the tissue overgrowth around the urethra constricts its opening leading to lower urinary tract symptoms (LUTS), including incomplete urination, frequency, urgency, nocturia, and decreased urine flow [3]. The prevalence of BPH-associated LUTS increases with age and it has been reported that approximately 80% of men experience BPH-associated LUTS by 70 years of age [4]. However, not every man with BPH symptoms seeks medical attention; most often, BPH patients only seek medical care when BPH-associated LUTS become bothersome or intolerable [1].
There is a variety of treatment strategies for BPH symptoms depending on symptom severity, together with patient discomfort and preference. These treatment strategies include lifestyle alterations, medical therapy, and surgical treatment [5]. Alpha-blockers such as tamsulosin are excellent first-line options of medical therapy [6]. Recently, there has been an increasing tendency towards the use of herbal medicines for different medical conditions. Pumpkin (Cucurbita) seeds are traditionally known around the world for their remedial effects on urinary tract complications, such as nocturia, urinary frequency, and stress urinary incontinence [7]. Pumpkins belong to the Cucurbitaceae family which includes various species such as Cucurbita pepo, Cucurbita moschata, and Cucurbita maxima [8]. Cucurbita pepo seed oil consists of high amounts of free fatty acids serving as a natural source of vitamins, proteins, trace elements, and polyunsaturated fatty acids, such as omega 3, 6, and 9 [9]. It is the phytosterol content of Cucurbita pepo seed oil that appears to interfere with the function of dihydrotestosterone produced by 5α-reductase which plays a major role in the process of BPH [10]. The phytosterol content varies among different Cucurbita species, including Cucurbita pepo and the previously mentioned Cucurbita moschata and Cucurbita maxima [11, 12]. However, only Cucurbita pepo is available in the Iranian market. Thus, in the current study, we aimed to compare the effects of Cucurbita pepo with tamsulosin for the treatment of BPH symptoms.
Conclusions
Both pumpkin seed oil and tamsulosin significantly reduced BPH symptoms; however, due to the higher reduction in IPSS scores from baseline to 1 month and 3 months, tamsulosin was more effective. The advantage of pumpkin seed was its lower side effects of pumpkin seeds. Further studies are required to confirm the role of pumpkin seed oil as an option for the treatment of BPH symptoms.
