Clinical Efficacy of Serenoa repens Versus Placebo Versus Alpha-blockers for the Treatment of Lower Urinary Tract Symptoms/Benign Prostatic Enlargement: A Systematic Review and Network Meta-analysis of Randomized Placebo-controlled Clinical Trials

In this network meta-analysis, we demonstrated the absence of clinically meaningful improvement of Serenoa repens extracts in a short-term follow-up. We could demonstrate only a long-term (12 mo) benefit of S. repens in the treatment of men with lower urinary tract symptoms/benign prostatic enlargement (LUTS/BPE). Before 12 mo, no clinically meaningful improvement in the International Prostate Symptom Score and peak flow of S. repens could be demonstrated. Overall, both hexanic and nonhexanic S. repens extracts showed a lower value of rank compared with all alpha-blockers. Based on the current results, patients can be better counseled on the efficacy of S. repens in the treatment of LUTS/BPE.