Permixon: place of drug in pathogenetic therapy of BPH

Benign prostatic hyperplasia (BPH) is a common disease of the ageing male population significantly affects quality of life by causing lower urinary tract symptoms. Several risk factors for the development of BPH have been identified, including age, genetics, hormones, growth factors, inflammation, and lifestyle factors. The present generation of medical treatments including α1-blockers, M-cholinolytics, 5α-reductase (5α-RI) and phosphodiesterase-5-inhibitors. Additionally, they all exhibit a variety of side effects forcing many patients to consider alternatives such as the use of plantderived medication. Permixon is a hexanic lipidosterolic extract of Serenoa repens consisting of a mixture of free and esterified long chain fatty acids, polyprenes, and phytosterols. Due to various ingredients, it shows a wide range of biologic activities within the prostate and demonstrates a specificity and selectivity for this organ. The main properties of Permixon are its antiandrogenic (inhibition of 5α-reductase activity), proapoptotic, antiproliferative and anti-inflammatory effects, as well as its capacity to intercept each of these distinct pathways. However, in contrast to other 5α-RI Permixon induces its effects without interfering with the cellular capacity of the prostate to secrete prostatespecific antigen. Moreover, this drug does not induce many of the side effects known to be associated with the use of synthetic pharmaceuticals. A systematic review of the literature and our own results show that Permixon is effective for relieving urinary symptoms due to prostate enlargement and improving urinary flow compared with placebo. This drug has efficacy similar to α1-blockers and shortterm 5α-Ш in relieving urinary symptoms is well tolerated and has a very limited impact on sexual function.