BANGSHIL
AND FORTEGE IN PROSTATIC CONGESTION
by
Dr.
M. K. Joseph, M.S., FFCS.,
Surgeon and Urologist,
Associate Professor of Surgery,
(Present Address :
Reprinted from
CURRENT MEDICAL PRACTICE Vol. 24, No. 8, Aug. 1980 pp 311-315
INTRODUCTION -
While Enlarged Prostate is given more attention, Prostatic
Congestion, though a common occurrence is often overlooked. Prostatic
congestion may occur in any age group, though most common between 20-40 years.
On the other hand, benign prostatic enlargement is more commonly seen over 40
years and in the senile, its incidence increasing with advancing age. Many
patients with vague urinary complaints are referred to this department. Urine
examination and other tests do not show evidence of urinary disease in most of
the cases. Modern medicine can offer proper antibiotic only when infection is
present and combined with prostatic massage, it gives rewarding results in
these cases. There is a tendency among surgeons to resort to pro - statectomy more often and a time has come to see that
prostatectomy is done selectively. The draw backs of Prostatectomy are not
brought to the notice of the patient before operation, such as post-prostatectomy
syndrome, some loss of sexual vigour etc. With these
in mind, we wanted to try Ayurvedic combination drugs and to evaluate their usefulness
in cases of prostatic congestion.
Bangshil and Fortege :
Bangshil
is described to have antiseptic and antibacterial properties; it increases body
resistance. Fortege is described to tone up genito-urinary
and neuroglandular systems. The combined therapy of
Bangshil and Fortege is described to act synergistically and relieves
prostatic congestion and associated urinary symptoms and particularly symptoms
like burning micturition, frequent micturition. difficult micturition, etc.
Composition of
Bangshil and Fortege
Each
tablet o f Bangshil contains:
Shilajit
(Asphaltum) 60 mg.
Guggul
(Balsamodendron Mukul) 40 mg.
Svarnamakshika Bhasma(Ferri sulphuratum) 30 mg.
Kasis (Ferr: sulphas) 30
mg.
Vanslochan
(Ba.mbusa arundinaecia) 12
mg.
Bang Bhasma (Tin Bhasma) 80 mg.
Sandalwood
oil 5
mg.
Chandraprabha Co. 168
mg.
Each
tablet of Fortege contains:
Kamboji
(Breynia patens) 56 mg.
Kuuncha
beej (Mucuna pruriens) 30 mg.
Suddha Kachura (Stryclmos yuxvQmica) 30
mg.
Samudra Sesh Beej (Argyria
speciosa) 15 mg.
|
Vardhara beej (Rourea s.antaloides seeds) - 15 mg. |
||
|
Asan (Withania Somnifera) |
15 mg. |
|
|
Vardha.ra mool (Rourea santaloids root) 15 mg. |
||
Laving
(Myrtus caryophyllus) 7.5 mg.
Piper (Piper longum) 7.5 mg.
Vacha
(Acorus calamus) 7.5 mg.
Mari (Piper nigrum) 7.5 mg.
Sunth
(Zingiber ofl'tcinale) 7.5 mg.
Chini
Kabab (Cubebs officinalis) 7.5 mg.
Akalkara
(Anocyclus pyrethrun) 7.5 mg.
Sukhad
Ver (Santalum album) 7.5
mg.
Jaiphal
(Myristica fragrans) 4.5
mg.
Javantri
(Arillus of Myristica fragrans) 3.0 mg.
Jeevanti
(Leptadenia reticulata) 56.5
mg.
MATERIALS AND
METHODS
One
hundred six cases that attended the Urology Department between January 1978 and
June 1979 were included in this study. Cases were taken at random and those
that could be followed-up regularly, such as their availability, nearness, etc.
were included for the study. 2 cases were of diabetes with hypertension, and
these were excluded from the study, that is only 104 cases were considered for
the study. The trial period was of 6 weeks. Fortege and Bangshil together were
given for six weeks in equal dosage. Urine examination and urine culture were
done in all the cases. IVP was done in 72 cases. Cystourethro5copy was done in
most of the cases. As culture for prostatic secretion was not very
contributory, it was not pursued. Diagnosis was made after digital examination
per rectum. VDRL was done in four cases where there was a history of exposure.
However, VDRL was found negative _ in these cases. The results of Bangshil-{Fortege
therapy were analysed after 6 weeks of treatment. , Repeat endoscopy was done
where necessary. Repeat Urine Culture was done only in those cases where it was
positive before the therapy. Repeat IVP was done in those cases where there was
severe pain and spasm of lower end of the ureter
before.
Age Group:
Prostatic Congestion appears to be nearly
equally distributed among the age groups of 20-45 –years (Table 1).
TABLE
1
Age
Group No of cases %
17-19
years 4 3.8
20-25 16 15.4
26-30 16 15.4
31-35
16 15.4
36-40
16 15.4
41-45
14 13.5
46-50
8 7.7
5155
8 7.7
56-60 6 5.7
Total 104 100%
Urologic Symptoms :
Each
patient had more than one symptom. Burning Micturition
and frequent micturition were the most common
symptoms with 67.3'ofo. There was 2 cases of urethral
discharge. There were 20 cases of haematuria.
Bleeding points could be seen during endoscopy. There
was no case of scanty urine or retention of urine in this series. Next to
burning micturition and Frequent Micturition,
the common symptoms were of Painful Micturition
(30.8%) and Difficult Micturition (13.5). Mean number
of symptoms per patient was 2.1 (Table 2.)
TABLE
2 Symptoms :(N = 104)
|
Burning
micturition
70 |
67.3 |
|
Painful
micturition
32 |
30.8 |
|
Frequent-
mictuirition
70 |
67.3 |
|
Haematuria 20 |
19.2 |
|
Difficult
micturition 14 |
13.5 |
|
Frecipitancy 4 |
3.8 |
|
Dribbling
2 |
1.9 |
|
Discharge
2 |
1.9 |
|
Scanty
Urine 0 |
- |
|
Retention
of Urine |
|
|
Mean
Symptoms |
|
|
Per
Patient: 2.1 |
|
|
Associated
Complaints : |
|
8
patients had pain in the hypogastrium, 8 had
back-ache and 28 patients had low back-pain and 2 had pain in the loins and 2
had pain in the testicles (Table 3.)
TABLE
3
|
Associated
Complaints |
: N = 104 |
|
|
Complaint |
No.
of cases |
|
|
|
(N
= 104) |
|
|
Pain
in hypogastrium |
8 |
7.7 |
|
Back-ache |
8 |
7.7 |
|
Law
back-pain |
28 |
26.9 |
|
Pain
in Loins |
2 |
1.9 |
|
Pain
in both testicles |
2 |
1.9 |
Urine
Examination -:
Urine
examination showed that in 56 cases RBCs
were seen ranging from 1-30 Id.P.F. and W,BC ranging from 1-40 H.P.F. Pus cells were seen in 10
cases. Albumin was found in 2 cases and in 2 cases sperms were seen. AFB was
negative in all the cases. In 34 cases urine was normal (NAD) (Table 4.).
|
Urine |
No. of cases (N = 104) |
% |
|
RBC
(1-30 HPF) |
.56 |
53.8 |
|
WBC
(1-40 HPF) |
56 |
53.8 |
|
Pus
cells |
10 |
9.6 |
|
,Albumin |
2 |
1.9 |
|
Sperms |
2 |
1.9 |
|
AFB |
0 |
|
|
NAD |
34 |
32.7 |
|
Urine
Culture : |
|
|
Urine
culture showed E. Coil in 14 Streptococci in 4 cases and culture was negative
in 86 cases (Table 5.)
TABLE
5
Urine
Culture
|
Culture |
No.
of cases |
|
|
F,
Coli Streptococci Negative |
14 4 86 |
13.5 3:8 82.7 |
|
Total |
104 |
100.0 |
|
IVP : |
|
|
IVP
was done in 72 cases. IVP was normal in 56 cases. 2 cases showed non-functioning
kidney left, 2 cases showed 2-3 oz of residual urine, 2 cases showed small
kidneys (both), 2 cases had Duplex Kidney left and 2 cases showed delayed
secretion left. 4 cases showed. spasm at, lower end of
the right ureter and 2 eases showed spasm at lower
end of the left ureter (Table 6.).
Prostate :
Diagnosis
was made by digital examination of the prostate; per rectum: While gross
enlargement was seen only in 2 patients, majority of patients had prostatic
Congestion (86 cases). Sixteen cases (15.4%) had congested as well as enlarged
prostate, Prostatic congestion was severe in 46 cases. - Moderate in 38 cases
and Slight in 2 cases (Table- 7.).
TABLE
6
IVP
|
IVP
No.
of cases |
% |
|
Non-functioning
Kidney |
|
|
Left
(Size normal) 2 |
1.9 |
|
Residual
Urine! (2-3 oz) 2 |
1.9 |
|
Spasm
in lower end of ureter. |
|
|
right
4 |
|
|
left
2 6 |
5.8 |
|
Small
Kidneys (both) 2 |
1.) |
|
Duplex
Kidney (Left) 2 |
1.9 |
|
Delayed
secretion (Left) 2 |
1.9 |
|
NAD
56 |
53.9 |
|
Not
Done 32 |
30.8 |
|
Total.
104 |
100% |
|
TABLE 7 |
|
|
Condition of the Prostate. |
|
|
Condition
No.
of cases |
% |
|
Congested
Prostate |
|
|
Severe
46 |
|
|
Moderate
38 |
|
|
Slight
2 86 |
82.7 |
|
Enlarged
Prostate 2 |
1.9 |
|
Congested
and Enlarged 16 |
15.4 |
|
Total
104 |
100.0 |
Bangshil
Plus Fortege Regimen :
Bangshil
+ Fortege were given each 2 lets, three times a day, for two weeks and then 1
tablet each, three times a day, for four weeks.
RESULTS AND
DISCUSSION
Prostatic
congestion completely disappear in 42 cases (40.4%).
It was Fair (Much Improved) in 44 cases -(42.3-%).
That is, satisfactory improvement was 82.7%. There was slight improvement in 6
cases (5.8%) and no improvement in 12 cases (11.5%). :
Symptomatic relief was evident in almost all the cases where symptoms of
burning micturition etc. disappeared. Where haematuria
was a presenting symptom, all the cases showed no
haematuria after therapy. There was
two cases with the presenting symptom of urethral discharge and the discharge
stopped. Those suffering from associated
back-ache, low back pain, etc. had remarkable relief of these and the
patients were happy at
this because these were affecting them; both physically and mentally.
Improvement occurred in most of the cases within first 2 weeks. Only 2 cases
came back with the symptom of dribbling after a few days of heavy drinking but with abstinence from
drinking and repeat treatment, they again improved.
Those
4 cases who had history of exposure before, but whose VDRL
was negative, also improved as the other cases. There was testicular pain in 2 cases which di-appeared with the therapy. There were 2 cases of loss of
penile erection and these regained the power of erection with the relief of
prostatic congestion and associated-symptoms. Urine. cultures that were positive before, were all negative on
repeat urine culture: after Bangshil + Fortege therapy. Improvement in sperm count
was obvious in cases with oligospermia (In four
cases)
(Table.
8.).
|
TABLE 8 |
|||
|
Results |
|
|
|
|
Result
|
No.of cases |
|
% |
|
Complete
Relief (Cured) |
42 |
40.4 |
|
|
Fair
(Much Improved) |
44 |
42.3 |
82.7% |
|
Slight
Improvement |
6 |
|
5.8 |
|
No
Improvement |
12 |
|
11.5 |
|
|
|
|
|
|
Total |
104 |
|
100.0 |
CONCLUSIONS
Bangshil
+ Fortege treatment had definite effect in relieving prostatic congestion Where there was gross enlargement (in 2 cases), the
prostatic symptoms disappeared. In those 16 cases where prostatic enlargement
was present along with prostatic congestion, the congestion disappeared
completely.
Some
cases were referred to the, author as ureteric colic,
but IVP showed no stones, but only spasm- of lower end of the ureter, right or left was present. Even Baralgan
did not give relief to these patients. It was good to see that the colicky pain
disappeared and repeat IVP in these cases after Bangshil-}-Fortege therapy
revealed disappearance of the ureteric spasm. Repeat
endoscopy in cases of haematuria
showed disappearance of the bleeding points.
As
cases of prostatic congestion are maie common and
more numerous than it is believed, this condition is often overlooked.
Prompt
diagnosis and treatment with Bangshil + Fortege will alleviate this condition
in the majority of patients in about two weeks. Bangshil + Fortege therapy is
found beneficial in this condition. No side or toxic effects were observed with
the use of this Ayurvedic combination.
ACKNOWLEDGEMENT
I
am thankful to M/s. Alarsin Pharmaceuticals,
Bombay-400023, for their cooperation.
REFERENCES
1.
Singh; T. B. and Chauhan, N. S.: Clinical study with
Fortege and Bangshil in cases of Benign Enlargement of Prostate, National
Medical Gazette,
2.
Wahab, M.A., Tejwani, B.
N., Fathak, L., and Surinder
Singh. : Bangshil and Fortege in Benign Prostatic Hypertrophy, Current Med. Pract.