1 Vaginal douche by kashaya

2. Vaginal utharavasthi using sneha

3. Uterine (Intrauterine) utharavasthi using sneha

Materials required

1 Vaginal douche can

2 Cotton gauze

3 Dettol, savlon

4 Artery forceps

5 Sponge holding forceps

6 Kidney tray

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

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.

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.

1 Cascos 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

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 Cascos 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 Cascos speculum. Ask the patient to lie down in supine position for 15-20 minutes.

It is usually done in infertility, intrauterine pathologies with 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.

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 Cascos bivalve speculum for proper visualization of cervix. Insert uterine sound to know the position of uterus. Remove the uterine sound and slowly insert Rubens canula in the same direction. Attach autoclaved medicine filled syringe to external end of Rubens 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.