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As such, it could be used for pre-service or in-service education and training, as a source of up-to-date, evidence-based recommendations, and as a self-education tool for health-care providers on the prevention, treatment, and diagnosis of RTIs.

Programme managers can use it as a starting-point for improving policies, programmes and training on the prevention and management of STI/RTI, adapting the information and recommendations as needed to local conditions.

Potentially suitable patients were given a micturition diary to assess nocturia and asked to return after 1 month.

At the baseline visit, the patients returned the micturition diary and completed the IPSS questionnaire including IPSS-related Qo L.

At all visits, blood pressure, concomitant medications and adverse events were recorded.

At the final visit, all the examinations and tests performed at screening were repeated.

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The sterol fraction of pumpkin seed includes the widespread delta-5-sterols, but the main fraction consists of delta-7-sterols, which are claimed to account for the therapeutic effects and have not been found in other sterol-containing plant extracts used in BPH treatment.

Therefore, the present three-armed study compared pumpkin seed and pumpkin seed extract with placebo in parallel groups.

The study was performed by German urologists in private practice in accordance with good clinical practice and the Declaration of Helsinki.

The study protocol was approved by the responsible ethics committee and the Federal Institute for Drugs and Medical Devices (Bf Ar M). Men between 50 and 80 years old with BPH/LUTS for ≥6 months were recruited if they had either never received any treatment (phytotherapeutic agents, α-adrenergic blocking agents and 5-α-reductase inhibitors) or had stopped such treatment ≥6 months prior to enrolment.

Patients eligible for randomization had an IPSS ≥13 and ≤19, IPSS-related quality of life (Qo L) ≥3, diary-recorded nocturia ≥2 times and peak urinary flow rate (Q100 ml. Extraction with ethanol 92% (w/w) gives a semisolid extract with a drug-extract ratio of 15-25:1.

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