Prostate cancer and enlarged prostate /Benign Prostatic Hyperplasia (BPH) are important public health problems in sexually active elderly males. Usually, men with these conditions experience symptoms ranging from frequency in urination, hesitancy, urgency, to trickling flow of urine. And in advanced stages, the patient cannot pass urine due to blockage in the passage of urine.The enlargement of the prostate gland in males has been a major ailment with very serious concern, especially because of the associated complications of severe urine retention, which causes severe pain, discomfort, anxiety and loss of consciousness and as a result could warrant urgent and emergent medical attention.There are various options of treatment depending on the stage of the disease with many urologists preferring medications in the early stages and surgery for the more advanced stages or complicated cases. Modern methods have been evolved to control the enlargement of the prostate through radiation, but most available synthetic drugs have not proved effective in curing the ailment. Scientists have identified natural recipes for ameliorating mild to moderate lower urinary tract symptoms (LUTS) in men with enlarged prostate. Top on the list are plant extracts of Pygeum Africanum and Urtica Dioica.Pygeum Africanum (African plum tree or bitter almond) is called emi or olowomefa in Yoruba, ka'danya in Hausa and osisi in Ibo. Commonly called nettle, big string nettle, common nettle, stinging nettle, Urtica dioica is a leafy plant found in most parts of Nigeria, but ubiquitous in the Southern parts. The Igbos call it agbara or akuwa; and it is named osokporode in Urhobo while to the Yorubas, it is ewe esinsin or esisi.Pygeum Africanum has been shown to be beneficial in treating BPH. It is especially helpful in increasing urinary function, often limited due to enlarged prostate. Historically, the bark was powdered and used to make a tea, which was taken by mouth for urinary problems.Moreover, a combination of African plum tree with stinging nettle was found to increase the effectiveness of each herb in improving urinary flow rate. A new study to evaluate the effect of a combined extract of Urtica dioica and Pygeum africanum on Lower Urinary Tract Symptoms (LUTS) in Nigerian men recorded a 69.1 per cent improvement in symptoms of BPH. The men were placed on the extract African plum tree and stinging nettle in the preparation form of Prostatonin over nine months (January 2009 to September 2009).When the scientists reviewed the International Prostate Symptom Score (IPSS) and the Postvoidal Residual Urine Volume (PVR) of the 107 patients that participated in the study, they found that 74 patients showed an improvement in their symptoms while 33 patients did not notice any improvement in their symptoms. However, no patient recorded worsening symptoms.In addition, the scientists reported no sexually related side effects with the use of the combination of African plum tree with stinging nettle.The scientists wrote: 'Though our evaluation was retrospective and patient population small, we did document some objective improvement in the IPSS of more than half of our patients. These were, however, patients with mild to moderate symptoms. There was also an improvement in the PVR in a sizeable number of patients.'Although it could be argued that these patients with mild to moderate symptoms could be managed by watchful waiting, we think Urtica dioica and Pygeum africanum in the preparation form of Prostatonin could be a useful option in those patients who desire some form of treatment devoid of any significant general or sexually-related side-effects.'According to them, 'although this study cannot be regarded as entirely conclusive, further randomized prospective clinical trials would be required. We believe that the preparation of plant extracts of Pygeum Africanum and Urtica dioica has a potential role in the treatment of some patients with mild to moderate LUTS from BPH.'The 2012 study entitled: 'Effect Of The Plant Extracts Pygeum Africanum and Urtica Dioica on Lower Urinary Tract Symptoms due To Benign Prostatic Hyperplasia in Nigerian Men 'was published in The Internet Journal of Urology.The researchers included O.A Omisanjo, S.O Ikuerowo, E.B Izuagba, J.O Esho and O.A Adegboyega, all from the Lagos State University College of Medicine, Ikeja.Previous studies on Pygeum africanum postulated that the extracts contained phytosterols and long chain fatty alcohols. Although the exact mechanism of action of the plant is unknown, its analysis suggests it modestly improves urinary flow rates.Also, several studies, including clinical trials at Lagos University Teaching Hospital (LASUTH), Ikeja have shown that a combination of Pygeum Africanum (African plum tree or bitter almond) with saw palmetto (Serenoa repens) significantly reduces urinary hesitancy, urinary frequency, the number of times patients need to wake up at night to urinate and pain with urination in men who experience mild-to-moderate symptoms. Pygeum has also shown promise in preventing combating and reducing the symptoms of prostate cancer and chronic prostates. In animal studies, pygeum showed an increase in the volume and viability of sperm in the semen. This indicates a possible use of this herb for treating male infertility.Traditionally, the bark of the tree was gathered and powdered and made into a tea, which was taken for genito-urinary complaints.Some of the less researched traditional uses of pygeum include use as an aphrodisiac, fever, impotence, kidney disease, malaria, hair loss, partial bladder outlet obstruction (BOO), sexual performance, urinary tract infections, inflammation, malaria, prostatic adenoma, prostatitis and psychosis.More recently in the USA, the phytotherapeutic preparations of Pygeum africanum and Saw palmetto have been marketed for prostate health including prostate cancer prevention and treatment.
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