Xipag® for LUTS Management in BPH Patients: Evaluating a Novel Nutraceutical Approach

Benign prostatic hyperplasia (BPH), a prevalent condition in aging men, often presents with lower urinary tract symptoms (LUTS) that significantly impair quality of life. Traditional pharmacologic interventions such as α1-blockers and 5α-reductase inhibitors remain mainstays of therapy but are frequently associated with adverse sexual side effects. In this context, the exploration of nutraceutical alternatives has gained traction, with a recent study by Lo Re et al. investigating the efficacy and safety of Xipag®—a formulation combining Graminex® G96® pollen extract and teupolioside—as a novel phytotherapeutic option for men with mild to moderate LUTS.

In this single-center, prospective observational study, 60 patients were enrolled, with 53 completing the full 3-month protocol. Participants received daily administration of Xipag®, and outcomes were assessed using the International Prostate Symptom Score (IPSS), Quality of Life (QoL) index, uroflowmetry, post-void residual (PVR), and validated questionnaires for sexual function (IIEF-5 and MSHQ-EjD).

The results demonstrated a statistically significant improvement in IPSS (median score decreased from 14 to 10; p < 0.001) and QoL scores (from 3 to 2; p < 0.001) over the study period. While uroflowmetry data showed a modest, non-significant increase in Qmax and a reduction in PVR, the consistency of symptomatic relief suggests a tangible benefit in urinary function. Importantly, sexual function and PSA levels remained stable throughout, supporting a favorable safety profile, especially when contrasted with the sexual dysfunction often reported with conventional BPH medications.

Patient adherence was high, with over 83% expressing a desire to continue therapy post-study. The tolerability of Xipag® was notable, with only one patient reporting a mild skin rash that resolved spontaneously. No serious adverse drug reactions were observed.

While these findings are promising, the study's observational design and short follow-up period are important limitations. Randomized controlled trials with longer follow-up are needed to confirm the durability of therapeutic effects and establish comparative efficacy versus standard treatments. Nevertheless, Xipag® emerges as a compelling option for men seeking relief from LUTS without compromising sexual health.

In conclusion, this study contributes valuable clinical evidence to the growing interest in nutraceutical therapies for BPH. Xipag® represents a safe and potentially effective intervention for LUTS, particularly appealing to patients concerned about the sexual side effects associated with traditional pharmacologic treatments.

Written by: Mattia Lo Re, Unit of Oncologic Minimally Invasive Urology and Andrology, University of Florence, Careggi Hospital, Florence; Department of Experimental and Clinical Medicine, University of Florence

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