clinical overview of the Uttara Basti procedure based on standard Ayurvedic practices
It’s crucial to follow a rigorous aseptic technique and ensure you have the proper instruments and knowledge to perform this procedure safely in your clinic.
Introduction to Uttara Basti Uttara Basti is a specialized Ayurvedic treatment involving the administration of medicated oil, ghee, or decoctions into the uterus (Garbhashaya) or urinary bladder (Mutrashaya) via the vaginal or urethral route. It’s primarily used to treat various disorders of the reproductive and urinary systems in both males and females.
Purva Karma (Pre-Procedure Preparation) This phase is crucial for ensuring the patient is ready for the procedure and to minimize any risks.
Patient Selection & Examination: A thorough examination is necessary to confirm the diagnosis and rule out contraindications like active infections, tumors, or pregnancy. Conduct routine investigations like hematological and urinary tests.
Patient Preparation: * Advise the patient to empty their bladder and bowels before the procedure.
A light, easily digestible diet (like gruel or milk with ghee) is recommended the night before.
Abhyanga (oil massage) and Svedana (fomentation) of the lower abdomen, hips, and pelvic region can be performed to relax the muscles and prepare the area.
Timing of Procedure (in females): The procedure is ideally performed during the Ritukala (the fertile period, just after the cessation of menses), as the cervical and uterine orifices are naturally open, allowing for better absorption of the medicine.
Pradhana Karma (The Main Procedure) This is the core part of the treatment, requiring a sterile environment and a meticulous approach.
Required Instruments & Medication: * Sterile equipment is non-negotiable. This includes sterile gloves, syringes, and specialized cannulas (like a uterine cannula or a Pushpanetra).
The medicated oil, ghee, or decoction must be chosen based on the patient’s specific condition and lukewarm for administration.
Antiseptic solutions (like Betadine) and sterile gauze. Positioning: * Place the patient in the lithotomy position (supine with knees bent and legs apart). You can use a gynecological examination table for this. Administration in Females (Vaginal/Uterine Route): 1. Cleanse the external genitalia and the vaginal canal with an antiseptic solution. 2. Use a speculum (like a Sims speculum) to visualize the cervix. 3. Gently introduce the sterilized uterine cannula into the vaginal passage, following its natural direction until it enters the uterus. The length of insertion should be carefully monitored. 4. Slowly and steadily inject the prescribed dose of medicated fluid (often 5-10 ml, depending on the classic text and the condition being treated) using a syringe attached to the cannula. 5. Once the medicine is administered, slowly withdraw the cannula. Administration in Males (Urethral Route): 1. After the patient has emptied their bladder, clean the urethral opening with an antiseptic solution. 2. A sterile, lubricated feeding tube or catheter is slowly and gently inserted into the urethra until it reaches the urinary bladder. 3. The medicated fluid is then injected using a syringe attached to the tube. 4. The tube is then removed. Paschat Karma (Post-Procedure Care) This phase is important for ensuring proper retention of the medicine and preventing complications. Rest: The patient should be advised to lie down in the same position for at least 15-30 minutes to ensure the medicine is properly absorbed and retained. Lifestyle Recommendations: * Advise the patient to avoid strenuous physical activity for 1-2 days. Sexual activity should be avoided for at least 2-3 days post-treatment. Instruct the patient to avoid urination for a few hours if the procedure was done through the urethral route.
Observation: Monitor the patient for any immediate discomfort or adverse reactions. Advise them to report any signs of infection, pain, or unusual discharge in the days following the procedure.
Performing Uttara Basti appears straightforward, but it requires meticulous attention to detail. The procedure must be conducted under strict aseptic conditions, preceded by thorough investigations, including:
1. Urine routine and microscopy: To rule out infections. 2. USG of scrotum: To detect any pathological conditions or deformities.
Procedure Steps:
1. Aseptic preparation: Clean the area thoroughly. 2. Tube preparation: Select the desired tube and lubricate it with a mixture of gel and oil/ghee. 3. Patient education: Provide clear instructions and explanations to the patient
Hello Since you’re a BAMS doctor, I’ll give you the authentic clinical point of view of Uttar Basti procedure . I can’t share personal email/WhatsApp, but I’ll guide you fully here.
✅Uttar Basti – Clinical Procedure
☑️INDICATION 👉PCOS / PCOD 👉Anovulation 👉Infertility due to tubal blockage (functional, not structural) 👉Dysmenorrhea, oligomenorrhea, amenorrhea 👉Recurrent pregnancy loss (where endometrium is weak) 👉Chronic endometritis
☑️Poorva Karma
1. Patient selection – Age: reproductive age group Rule out infections (vaginal / pelvic) Ensure patient is not pregnant
2. Timing – Usually after cessation of menses (day 6–12 of cycle, follicular phase). Avoid during menstruation, suspected pregnancy, PID.
3. Preparation – Patient is advised mridu snehana & swedana 2–3 days prior. Local cleaning of genitalia with Triphala kwatha / Panchavalkala kwatha.
✅Pradhana Karma
1. Position – Lithotomy position. 2. Aseptic precautions – very important (similar to IUCD insertion). 3 Drugs / Sneha dravyas – Phalaghrita Shatavari ghrita Kshirbala taila Dhanwantaram taila Combination of medicated oils/ghritas (decided as per condition).
☑️Procedure –
➡️Expose cervix with speculum, clean with sterile swab dipped in Triphala kwatha.
➡️Insert tube through cervix gently into uterine cavity (about 4–6 cm).
☑️Attach syringe containing lukewarm medicated oil/ghrita and instill slowly.
☑️Withdraw tube gently and allow patient to lie in supine position with buttocks elevated for 10–15 minutes.
✅Paschat Karma
Patient should rest for at least 30 minutes. Avoid exertion, intercourse, exposure to cold. Light warm food on that day. Course: 3–6 sittings in one cycle, repeated for 2–3 cycles as per condition.
❗ Precautions ➡️Always maintain strict aseptic precautions (risk of infection → endometritis). ➡️Contraindications: active pelvic infection, pregnancy, unexplained vaginal bleeding, cervical stenosis, acute PID. ➡️Start with smaller dose first to test tolerance.
Hope you found this helpful😊
Warm Regards Dr Snehal Vidhate
If Any doubts be free to message
You can also watch some YouTube videos or go to any near by panchakarma therpy center to get some practical insights
Uttar basti has to be done in sterile area, with proper setup for a comfortable lying of patient., Three stages of procedure 1)Purva karma 2) Pradhan karma, 3) paschat karma. It’s best to first be an observer on-site. Later do in presence of senior doctor and then you can do it confidently on a patient.
HELLO DR. NARGIS,
1.Consider attending workshops or training programs focused on Uttar Basti to enhance your knowledge and practical skills.
2. Maintain detailed case records and consider participating in research to contribute to the growing body of evidence supporting Uttar Basti’s efficacy.
3.Explore potential collaboration with practitioners of other systems of medicine to offer a more integrative approach, particularly in complex cases like infertility.
4.Clearly explain the procedure, its benefits, potential side effects, and precautions to your patients to build trust and ensure informed decision-making.
5.Maintaining strict aseptic precautions during the procedure is paramount to minimize the risk of infection.
6.A thorough pre-procedure assessment is essential, including a detailed medical history, physical examination.
PRADHANA KARMA The patient is positioned in the dorsal lithotomy position (supine with knees bent and legs apart). After ensuring the bladder and bowels are empty and performing local cleansing with antiseptic solutions, a sterile catheter or uterine cannula (e.g., Rubin’s cannula, IUI cannula) is gently inserted. Warmed medicated oil or decoction is then slowly instilled into the uterus or bladder. The amount of fluid administered varies based on the specific medicament and patient’s condition.
PASCHAT KARMA The patient should rest in a supine position, often with the head in a low position or with legs crossed and elevated, for a period (at least 2 hours is recommended after vaginal/uterine administration) to facilitate absorption and prevent vasovagal shock. Hot fomentation over the abdomen or lower back can alleviate any discomfort. A light diet is advisable after the procedure.
TIMING For women, Uttar Basti is often administered during the follicular phase (early morning or afternoon) or just after menstruation (Ritukala), as the uterine opening is considered more receptive then. Urinary Uttar Basti can be administered at any time.
FREQUENCY The number of sessions required varies depending on the condition.It can range from a few sessions (e.g., 3-5 days consecutively or 3-8 sessions spaced weekly or over a menstrual cycle) to longer courses of treatment. I also recommend Niruha Basti (cleansing enema) prior to Uttar Basti for better results.
Take Care 😊
Kind Regards, Dr.Isha Ashok Bhardwaj.
HELLO DR. NARGIS,
Uttarbasti is an Ayurvedic therapeutic procedure in which medicated oils or decoctions are instilled into the uterus (per uterthra in male/ per vagina in females)
INDICATIONS -female infertility due to tubal block, an ovulation, endometrial receptivity issues -dysmenorrhea, oligomennorrhea, amenorrhea -PCOS/PCOD -chronic pelvic infections -recurrent abortions -male infertility low sperm motility, oligospermia, ejaculatroy dysfunction, stricture urethra
CONTRAINDICATIONS -active pelvic infection -menstruation during period cycles -preganacy -acute fever, weakness, systemic illness
PRE-PROCEDURE (PURVAKARMA) 1) patient selection and consent= rule out pregnancy and infections 2) preparation= light diet, bowel and bladder evacuation 3) Local sepsis= perineal cleaning with stripe solution 4) Snehana and swedana may be given prior, depending on case
PROCEDURE (PRADHANKARMA) 1) Patient in lithotomy position 2) Sterile , disposable rubber catheter or Uttarbasti cannula used 3) Warm medicated oil or decoction (lukewarm ~ 37 degree celsius) 4) Dosage 2-5 ml oil (ghrita or taila) / 10-20 ml kwatha depending on condition 5) Medicine instilled slowly into uterine cavity (per vagina) or urinary bladder/urethra in males 6) Patient rests in supine position for 15-20 minutes
POST-PROCEDURE (Paschatkarma) -Advice rest for the day -light, warm, easily digestible diet -avoid intercourse, exertion and cold exposure for 24-48 hrs
COMMONLY USED MEDICINES
FOR FEMALES -phala ghrita -shatapushpa taila -kshara taila -bala taila
FOR MALES -bala taila -sahacharadi taila -dashmoola kwatha
COURSE -Usually given for 3-5 days after menstruation in females -May repeat for 2-3 cycles depending on condition
HOPE THIS MIGHT HELP YOU
THANK YOU
DR. MAITRI ACHARYA
Hlw Dr Nargis ji,
Thank you for your interest in learning more about Uttarbasti, a highly specialized Ayurvedic Panchakarma procedure. Since you’re a BAMS-qualified doctor, you’re already familiar with the theoretical framework, and it’s excellent that you’re looking to deepen your clinical skills.
What is Uttarbasti?
Uttarbasti (also spelled Uttarabasti) is a medicated oil or decoction enema administered through the urethral or vaginal route, primarily used for: Female reproductive disorders (like PCOS, infertility, dysmenorrhea) Male urogenital issues (like oligospermia, prostate disorders, etc.) It is considered one of the most effective Shodhana (purificatory) therapies for Uttara roga (genito-urinary disorders).
Clinical Details of the Procedure ✅ Indications:
Female: PCOD, infertility, endometriosis, dysmenorrhea, cervical erosion Male: Prostatitis, oligospermia, urethral stricture, urinary tract infection
❌ Contraindications: During menstruation Active infection (UTI, PID) Pregnancy Structural abnormalities (without diagnosis)
🩺 Preparation (Poorva Karma):
Patient Selection – Nirogi status and Prakriti analysis Consent & Counseling – Inform about benefits, risks, and post-procedure care Local Abhyanga & Swedana – For better dosha elimination and comfort Bladder & Bowel should be empty
🧴 Dravya (Medications) Used:
Taila (Oils): Phalaghrita, Bala Taila, Shatavari Taila, Ashwagandha Taila Kwatha (Decoctions): as per the condition (e.g., Dashamoola kwath)
🧫 Dose & Instruments:
Usually 3–5 mL of medicated oil for females (vaginal route) 1–3 mL for males (urethral route) Sterile disposable syringes with rubber catheter (size depending on the patient) Aseptic technique is mandatory
🩻 Procedure (Pradhana Karma):
Patient in lithotomy position (for females) or supine (for males) Clean the local area with antiseptic solution Insert sterile rubber catheter (6F–8F for females, 4F–6F for males) Administer warm (body temperature) oil/decoction slowly and gently Remove catheter carefully and ensure patient is comfortable
🧘 Post-Procedural Care (Paschat Karma): Ask the patient to lie down for 10–15 mins Advise light diet for the day Avoid intercourse, bathing, or exertion for 24 hours Repeat schedule: Depending on the condition, 3–7 sittings, once every alternate day or as advised
⚠️ Important Clinical Tips: Always maintain aseptic conditions Use single-use syringes and catheters Maintain confidential documentation Monitor for any allergic or adverse reactions.
I’m not able to provide personal email or WhatsApp numbers, but I can continue to guide you right here.
-Dr Sanchi Damodhar
Uttarbasti is a specialized Ayurvedic procedure used primarily for managing gynecological and urological conditions. It involves the administration of medicated oils or decoctions directly into the uterus or urinary bladder, depending on the condition being treated. From a clinical perspective, there are several key aspects to consider for the safe and effective performance of this procedure.
Before beginning uttarbasti, it’s crucial to perform a detailed assessment of the patient’s dosha imbalance, agni status, and prakriti. Ensure that the patient’s condition warrants uttarbasti and that there are no contraindications, such as pregnancy or active infections.
The preparatory phase involves snehana (oleation) and svedana (fomentation) to prepare the body. Administer these treatments for 3-5 days. That’s important to soften and liquify the doshas, making them easier to eliminate. Diet should be easy to digest, avoiding heavy, spicy or very cold foods, focusing on warm, cooked and light meals.
During the procedure, ensure all instruments are sterilized to prevent infections. Position the patient comfortably, typically in the lithotomy position for females or supine for males. Use a specially designed Uttarbasti katheter appropriate for the gender of the patient. After gentle application of lubrication, carefully insert the catether with utmost precision.
The therapeutic solution, often a warm medicated oil or decoction, is then administered slowly. Females typicaly receive medication into the uterus, while males receive into the urinary bladder. Close monitoring of the patient’s response is vital through the procedure to immediately address any adverse reactions or discomfort.
After the procedure, advise the patient to rest and avoid demanding activities to ensure effectiveness of therapy, encourage them to intake light, sattvic foods to aid in proper digestion and dosha balance. Follow-ups are crucial to monitor progress and make necessary adjustments.
For specific queries or further information, please consult relevant Ayurvedic texts or clinical guidelines. Engaging in workshops or seminars conducted by experienced practitioners can enhance your comprehension and execution of this specialized technique.
HELLO DR.
I can’t share personal contact details like email or WhatsApp, but I can definitely help you here
UTTAR BASTI= clinical point of view
INDICATION= female infertility, dysmenorrhea, endometriosis, recurrent abortions, Fallopian tube block, an ovulation, and certain Male infertility cases
TIMING (for women)= usually given after menstruation, in proliferative phase around 6th-12th day of cycle
ROUTE= through urethra in males or through cervix in females
PREPARATION -Snehana and swedana= local or whole body -basti= sometimes preceded by anuvasana basti or Niruha basti -proper aseptic measures are mandatory
MAIN PROCEDURE -Position= lithotomy for women -cleanse local area with sterile swab - use sterile meta or disposable catheter -lukewarm medicated oil/ghee/decoction 3-5 ml for females , 2-3 ml for male is slowly introduced into uterus / bladder
COMMONLY USED MEDICATIONS -phala ghrita, Triphala Ghrita, shatavari taila, Bala Taila, dhanwantaram taila, kshirabala taila etc
AFTERCARE -patient should rest supine for 20 min -light diet, avoid exertion and intercourse on procedure days -monitor for pain, spotting or infection
PRECAUTIONS -must maintain strict asepsis to prevent infection -contraindicated in pregnancy, pelvic inflammatory disease, active vaginal / uterine infection, menstruation -should always be performed under proper clinical setup with emergency backup
THANK YOU
DR. HEMANSHU MEHTA
I’m unable to share personal contact information, but I can provide a detailed overview of the Uttar Basti procedure from a clinical perspective right here. Uttar Basti is an important Ayurvedic procedure used primarily for gynecological and urinary conditions. It’s a type of Panchakarma therapy where medicated oils or decoctions are administered into the uterine or bladder cavity. This method is highly regarded for conditions like infertility, anovulation, ovarian cysts, and even certain urinary disorders.
The procedure involves the introduction of medicated oils or decoctions, like tila taila (sesame oil) or specific herbal preparations, directly into the uterus or urinary bladder. The choice of medicated substance depends on the patient’s constitution (prakriti), doshic imbalance, and specific conditions being treated. Performing Uttar Basti requires thorough knowledge, especially with the anatomical sophistication and aseptic precautions that must be observed.
First, the patient is typically prepared with internal Snehan (oleation) and Swedan (sudation) to ensure the body’s channels are open and capable of absorbing the medicines. Then, under aseptic conditions, a specially designed catheter or pipette is used to introduce the medication into the desired cavity. For uterine administration, this is done through the vaginal route, whereas urinary administration involves the urethral passage. Timing is crucial, generally recommended a few days after menstruation for women.
The practitioner needs to monitor the patient for any adverse reactions post-procedure, like discomfort, pain, or unusual discharge, which might indicate complications. It’s crucial also to maintain proper hygiene and avoid contamination during the process to prevent any infections. If you’re thinking of incorporating this into your practice, ensure you’re fully trained in its safety and efficacy. Also, consider patient selection carefully, as not all conditions or individuals are suitable candidates for Uttar Basti.
