Uttaravasthi
(Female)
Usually in females, utharavasthi done by three ways.
1 Vaginal douche by kashaya
2.Vaginal utharavasthi using sneha
3. Uterine (Intrauterine) utharavasthi using sneha
1. Vaginal douche
Usually done in conditions like cervicitis, cervical erosion, HPV-human papilloma virus, trichomanas vaginalis infection, cervical intraepithelial neoplasia using decoction.
Materials required
1 Vaginal douche can
2 Cotton gauze
3 Dettol, savlon
4 Artery forceps
5 Sponge holding forceps
6 Kidney tray
Drugs required
1 Nalpamaradi kashaya
2 Triphala kashaya
3 Aragwadadhi kashaya
4 Panchathikthaka kashaya
Time of administration
9.30 am - 1 pm in OPD base
Dose
1500ml of kashaya
Procedure
Ask the patient to void the urges before the procedure. Give snehana and swedana over pelvic and lumbosacral region. Patient should lie in lithotomic position. Clean the vulva region with the swab dipped in antiseptic lotion.
Take kashaya in vaginal douche can; confirm nozzle of the can is closed properly. Insert nozzle through vaginal orifice allowing flow of kashaya in all fornices and around cervix to wash out. After complete cleaning, remove nozzle and again swab out vagina with cotton gauze.
In case of infections, varthi like Kushtapippalyathi varthi can be used after vaginal douche.
2 .Vaginal utharavasthi
Usually used in non infective conditions of vagina and cervix, 1 & 2 0 uterine prolapse, female infertility, cervical erosion, cervicitis, cervical intraepithelial Neoplasia, endometriosis etc.
Materials required
1 Casco’s bivalve speculum
2 Sponge holding forceps
3 Artery forceps
4 Betadine, savlon
5 Sterilized gauze
6 Syringe 10-30 ml capacity
7 Kidney tray
8 Medicated sneha autoclaved
Drugs required
1 Phalasarpis
2 Dhanwantharam gritham
3 Shatpala gritham
4 Shashtika tailam
5 Varanadhi gritham
6 Jathyadhi gritham
7 Gugguluthikthaka gritha
8 Kalyanaka gritha
9 Mahathikthaka gritha
Time of administration
According to the condition, mostly in morning hours
Dose of medicine
15-20 ml
Procedure
Autoclave all required materials. Prepare the patient with local shaving of pubic hair. Snehana and swedana of katee pradesa should be done. After voiding urine, ask the patient to lie down on utharavasthi table in lithotomic position. Cover all other parts except genitalia with surgical towels and fix with towel clips. Clean the exposed area with cleaning agents using sponge holding forceps and gauze. Clean vagina using artery forceps and gauze. Fix Casco’s bivalve speculum for proper visualization of cervix. Take autoclaved medicine in syringe and slowly injecting vagina till it fully covers the os reaching external os. Keep plain gauze and remove Casco’s speculum. Ask the patient to lie down in supine position for 15-20 minutes.
3 Intrauterine utharavasthi
It is usually done in infertility, intrauterine pathologies with sneha
Materials required
Cusco’s bivalve speculum
Uterine sound
Ruben’s canula
Sponge holding forceps
Artery forceps
Sterile gauze
Towel with clips
Kidney tray
Medicated sneha
Drugs used
1 Phalasarpis
2 Kalyanaka gritha
3 Dhanwanthara gritha
Dose: 2-4 ml.
Time of administration
Done in rithukala after doing kashayavasthi with proper snehana and sodhana.
Procedure:
Snehana and swedana of kateeprdesha is done. Sodhana is done as yogavasthi or kala vasthi or rajayapana vasthi. Patient is prepared with shaving of the pubic hair. The patient is asked to lie down on the table in lithotomic position after voiding urine. Cover the part except genitalia with surgical towels and fix with towel clips. Clean the exposed area with cleaning agents using sponge holding forceps and gauze. Clean vagina with artery forceps and gauze. Fix the Casco’s bivalve speculum for proper visualization of cervix. Insert uterine sound to know the position of uterus. Remove the uterine sound and slowly insert Ruben’s canula in the same direction. Attach autoclaved medicine filled syringe to external end of Ruben’s canula. Push the medicine slowly. Remove the syringe, canula and speculum carefully. After the procedure keep a pichu in the vagina. Ask the patient to lie down in supine position for 15-20 minutes, remove the pichu when patient feels next urge of Micturition.
Complications
Bleeding or spotting
Medication is not required; it will subside on the next day.
Abdominal pain
Managed with dhanwantharam gutika, dhanwantharam kashaya and sapthasara kashaya
Precautions
1 Proper sterilization
2 TT injections before the procedure
3 Use of Biogest, Septilin tab during the procedure to avoid infection
4 Push medicines very slowly to avoid entry into the peritoneum, which may
cause severe peritonitis, and spilling into appendages.
Utharavasthi in male
Utharavasthi is used in males, commonly in sexual dysfunctions like erectile dysfunction, premature ejaculation, and in certain seminal abnormality like oligosprmia.
Medicines used
Ksheerabala taila
Dasamoola taila
Bala taila
Brihat chagalyadi gritha
Mahanararayana taila. etc
Procedure:-
Local shaving of pubic hair should be done and the patient is asked to void the urine just before the procedure starts. Patient must lie down on supine position on the clean table by exposing the part. The hands are flexed and clasped below head. Wash the genitalia and the surrounding area with the savlon by using sponge holding forceps & gauze. Retract the prepuce completely and wash thoroughly the glans penis & then apply Betadine to glans penis. The physician having gloves after washing hands spread the surgical towel over patient, exposing the penis. Towel clips may be applied. When once the assistant transfers the autoclaved medicine into steel bowel, the medicine is filled into the syringe. Fix the catheter to the nozzle of the syringe, push the oil to the tip of the catheter. Lubricate the catheter with the xylocaine jelly. Gently introduce the catheter into the urethra. Slowly introduce the catheter into the bladder. Ensure the catheter has entered the bladder, and then slowly inject the medicine into the bladder. If more amount of medicine has to be injected clamp the catheter with artery forceps, remove the syringe & then inject the medicine with same syringe or by another. When once the injection of medicine is over remove the catheter & allow the patient to lie down in the same position for 5 to 10 minutes and then patient may be sent home. Check the tip of the catheter to ensure that there is no any bleeding.
Dose
25–30ml
Retention:-
Usually 3-6hrs
