Serenoa repens (Saw palmetto) for Lower Urinary Tract Symptoms (LUTS): The Evidence for Efficacy and Safety of Lipidosterolic Extracts. Part I

The document reviews the efficacy and safety of lipidosterolic extract of Serenoa repens (LSESr), also known as saw palmetto, in treating Lower Urinary Tract Symptoms (LUTS). The review analyzed 56 studies, with an average of 270 patients per study, over a mean duration of 5 months. The author found that out of 15 evaluable studies, 12 showed efficacy for Serenoa repens, while 3 did not. The document criticizes the 2012 Cochrane meta-analysis and the American Urological Association Guidelines (AUAG 2014) for not considering many evaluable studies showing favorable responses with Serenoa repens. Two studies, Debruyne 2002 and Hizli 2007, found that improvements in International Prostate Symptom Score (IPSS), quality of life (QoL), and peak urinary flow (Qmax) with LSESr were comparable to those with tamsulosin, a common medication for LUTS. The document concludes that LSESr is safe and tolerable, as consistently reported in peer-reviewed clinical publications and meta-analyses. However, the clinical evaluation of LSESr has been negatively impacted by variability in the composition and quality of LSESr, a primary focus on LUTS progression being related to prostate enlargement, and a need for long-term studies of LSESr.