UTTARABASTI PROCEDURE

• Uttarabasti is a specialized procedure in Panchakarma, mentioned extensively in Ayurvedic texts like Sushruta Samhita, Charaka Samhita, and Ashtanga Hridaya.

• It is a type of basti administered through the urogenital route, used mainly in Mutravaha Srotas, Shukravaha Srotas, and Artavavaha Srotas disorders.

SANSKRIT REFERENCE:
सुश्रुत संहिता, चि.स्थान 37/29
"मूत्राशयविकारेषु योनिविकारेषु चोत्तरो बस्तिः प्रशस्यते।"

INDICATIONS OF UTTARABASTI

• Mutraghata (urinary obstruction)

• Ashmari (urinary calculi)

• Yoni Vyapad (gynecological disorders)

• Artava Kshaya (amenorrhea/oligomenorrhea)

• Shukra Dosha (infertility due to seminal disorders)

• Rakta Pradara (menorrhagia)

• Chandraprabhavati and other formulations are often used in such cases.

MODERN CORRELATIONS:

• Chronic cervicitis

• Pelvic Inflammatory Disease (PID)

• Dysfunctional uterine bleeding (DUB)

• Benign prostatic hypertrophy (BPH)

• Male and female infertility

• Urethritis

• Cystitis

CONTRAINDICATIONS OF UTTARABASTI

• Acute urinary tract infection

• Active vaginal bleeding

• Pregnancy

• Pelvic abscess or tumors

• Active genital infections (e.g., herpes, gonorrhea)

• Recent surgery of the pelvic area

• Structural abnormalities blocking the path of insertion

SANSKRIT REFERENCE:
अष्टाङ्गहृदय, सूत्रस्थान 19/81
"न सन्दधीत गर्भिण्या योनौ बस्तिं विशेषतः।"

UTTARABASTI – PROCEDURE STEP-BY-STEP

PREPARATORY PHASE (POORVA KARMA)

• Snehana (internal and external oleation): Administer suitable sneha (e.g., Goghrita or Taila)

• Swedana (mild fomentation): Local swedana to reduce stiffness

• Assessment: Ensure bladder is empty; rule out infection or inflammation

• Consent and Privacy: Inform the patient about the procedure and obtain written consent

INSTRUMENTS REQUIRED

• Clean uttarabasti netra (metal or plastic)

• Sterile syringe (preferably disposable 10-20 ml)

• Lubricated medicated oil or decoction

• Cotton swabs, gloves, antiseptic lotion

POSITIONING OF THE PATIENT

• In females: Lithotomy position

• In males: Supine position with flexed knees

• Maintain aseptic precautions throughout

PRADHANA KARMA (MAIN PROCEDURE)

• Cleanse genital area with antiseptic solution

• Lubricate the nozzle of uttarabasti netra

• Gently insert into the urethra (male) or vagina/cervix (female)

• Slowly instill 5-10 ml of warm medicated oil or decoction

• Retain for a few minutes before removing the netra

• Patient is advised to rest in the same position for 10–15 minutes

DRAVYA (MEDICATED SUBSTANCES) USED

• Taila-based: Bala Taila, Shatavari Taila, Kshara Taila, Narayana Taila

• Kwatha-based: Gokshura Kwatha, Punarnava Kwatha

• Ghruta-based: Phala Ghrita, Shatavari Ghrita

SANSKRIT REFERENCE:
सुश्रुत संहिता, चि. 37/38
"यथास्वं स्नेहकषायैः साधितं वस्तिमार्गगं।"

POST-PROCEDURE CARE (PASCHAT KARMA)

• Patient is advised to rest for 30–60 minutes

• Avoid exposure to cold wind or bath immediately after the procedure

• Light diet should be given (laghu ahara)

• Monitor for any discomfort, pain, burning micturition, fever, or infection

• If symptoms of infection appear, consult for modern antimicrobial therapy

• Advise the number of sittings based on condition (usually 3–7 sessions)

THERAPEUTIC BENEFITS OF UTTARABASTI

• Direct action on reproductive and urinary organs

• Enhances tone and function of pelvic organs

• Balances Apana Vata and pacifies localized doshas

• Nourishes local tissues with snehana and rejuvenation effects

• Improves fertility by correcting artava and shukra dushti

• Breaks down srotorodha (blockages) and enhances circulation

• Promotes healing of mucosal surfaces in cervix and urethra

MODERN BENEFITS

• Improves uterine blood flow and endometrial receptivity

• Increases seminal parameters like sperm count and motility

• Used in modern Intrauterine Drug Delivery (IUDD) concepts

• Minimally invasive, low-cost, and repeatable therapy

• Provides an alternative for chronic pelvic and urinary conditions

PRECAUTIONS AND COMPLICATION MANAGEMENT

• Ensure strict asepsis

• Use freshly prepared and sterile medications

• Avoid during menstruation or ovulation (in females)

• Stop if there is intense pain, bleeding, or allergic reactions

• In case of urinary retention or hematuria post-procedure, manage accordingly