Pygeum (Prunus africana) is traditionally used in African herbal medicine for urinary tract and prostate health, particularly to alleviate symptoms associated with benign prostatic hyperplasia (BPH). Its use has garnered scientific interest, and several clinical studies have investigated its efficacy. Meta-analyses and systematic reviews, including a Cochrane review (2002), suggest that pygeum extract may provide modest improvement in urinary symptoms and flow measures in men with BPH compared to placebo. Reported benefits include reduced nocturia, increased urine flow, and decreased residual urine volume.

The proposed mechanisms include anti-inflammatory effects, inhibition of prostatic fibroblast proliferation, and modulation of hormones involved in prostate growth. However, many studies are relatively small, of short duration, and vary in extract standardization, making definitive conclusions difficult. Recent guidelines note that while pygeum shows some promise, the quality of evidence is low to moderate and more rigorous, longer-term studies are needed to establish efficacy and safety.

In summary, pygeum's use for urinary system support, especially BPH-related symptoms, is supported by both traditional use and a moderate amount of scientific evidence, but is not yet considered a first-line therapy due to limitations in research quality.