Phytotherapeutic agents have gained widespread usage in the treatment of benign prostatic hyperplasia/lower urinary tract symptoms. They are marketed as over-the-counter medications in the United States and by prescription in many European countries. Although numerous mechanisms of action have been postulated, it is uncertain which of these are responsible for their clinical response. The efficacy of these agents has not been conclusively proven. Almost all the studies with these products have not been placebo-controlled, double-blind trials of at least 6 months' duration. Thus, the magnitude of the clinical effect is uncertain. It is impossible to compare the phytotherapeutic agents-either the single or multiple extract products-because manufacturers use different extraction processes. So each agent/product must be studied individually. Until more appropriately conducted trials are undertaken, the efficacy of phytotherapeutic agents will remain unproven.
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