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
