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Pourusha Vasti Male Uttara Vasti

Pourusha Vasti Male Uttara Vasti

By
Dr KSR Prasad
@ CME on 27-11-2016
Ayurved Vyaspeeth
Shri Ayurved College
Nagpur
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Pourusha Vasti Male Uttara Vasti

Male (Purusha) Introduction


undoubtedly strong in
many occasions but when
he becomes weak, aged or
diseased the
management of Pourusha
Vasti starts
Pourusha Vasti is an
exclusive Male Uttara
Vasti organized for the
(MSD) Male Sexual
Dysfunction or (BPH)
Benign Prostate
Hypertrophy
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Pourusha Vasti Male Uttara Vasti

Male Strength
Male @ conjugation
Transfers the genes to the offspring
through semen
Semen even though in millions of
count
Only one is successful
Environment, Food, Occupation, Habits,
etc. influence the harmony
Prostate Gland: A firm partly muscular
chestnut sized gland in males at the
neck of the urethra; produces a viscid
secretion that is the fluid part of semen

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Introduction
There is no such term Pourusha Vasti exists in
classical texts
Pourusha Vasti is a coined term to denote the
importance of Pourusha Granthi (Prostate)
management through Uttara Vasti
The alternative route (uttara marga)
administration of the medicine is termed as
Uttara Vasti
Common alternative routes are Urethral in
Male and Vaginal in Female apart from Urinary
bladder route
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Pourusha Vasti Male Uttara Vasti

Etymology

Vasu Vasane Achadane Nivase


It means any substance is placed to be
resident of or covered with is called as Vasti
The Uttara Vasti is called as it is given from
Uttara Marga (alternative route) and/or as a
better qualitative method

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Classification of Vasti

Sthaneeya Vasti Uttara Vasti Karma


Purva Vasti Karma
Karma

Vrana Vasti

1
Niruha Vasti
1
MutrashayaVasti
2
Anuvasana Vasti GarbhashayaVasti
2

3
Pourusha Vasti

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Knowing about Uttara vasti


What is Uttara Vasti?
It is a practice of administering the medicine
Per urethra in to seminal vesicles = Pourusha Vasti
Per urethra in to bladder = Mutrashaya Vasti
per uterine = Garbhashaya Vasti
The medicine includes
Ghruta Vidaryadi Ghruta, etc
Taila Narayana Taila, etc
Kashaya Dashamula Kashaya, etc

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Applied Shareera
Structures concerned are -
Glans penis
Urethra
Prostate gland
Vas deferens
Testicles
Bladder
Evacuated liquids are
Urine
Semen

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Surface Anatomy
The common structures
intervene are
Urethra - Urinary
Bladder sphincter
Urethra Prostatic
urethra ductus
deference-seminal
vesicles epidydimis
testes

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Applied Physiology
SEMINAL FLUID:
N UTRITION TO SPERMS: Fructose and other nutritive
substances in seminal fluid are utilized by sperms after
being ejaculated into the female genital tract.
CLOTTING OF SEMEN: Immediately after ejaculation,
semen clots because of the conversion of fibrinogen from
seminal fluid into fibrin.
Prostate
Prostate fluid is a thin, milky and alkaline fluid. It forms
30% of total semen.
MAINTENANCE OF SPERM MOTILITY: Prostatic fluid
provides optimum pH for the motility of sperms.
Generally, sperms are non-motile at a pH of less than 6.0.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Applied Physiology
SPERM
Sperm is the male gamete (reproductive cell), developed in the
testis. It is also called spermatozoon (plural = spermatozoa).
Matured sperm is 60 long.
Sperm Count
Total count of sperm is about 100 to 50 million/mL of semen.
Sterility occurs when the sperm count falls below 20 million/mL.
PROPERTIES OF SEMEN
1. Specific gravity : 1.028
2. Volume : 2 mL to 6 mL per ejaculation
3. Reaction : It is alkaline with a pH of 7.5. Alkalinity is due to
the prostate fluid.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Applied Physiology

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Eligible Male for Related to urinary Bladder


13 varieties of mootra Dosha
Uttara Vasti Mutouksada, Mutra jathara, Mutra
krichra, Mutrotsanga, Mutra kshaya,
Mutraateeta, Asteela, Vtavasti,
Ushnavata, Vtakundalika, Raktagrandhi,
Vidwighata, and Vasti Kundalika
Mutra sharkara
Ashmari
Vasti shoola
Related to Genital
Vankshana shoola
Shukra Dosha
Sukraotseka
Dhwajabhanga
Klaibya

Susruta Chikitsa 37/125-126, Charaka Siddhi 9/71

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Examination of
Pourusha Vasti Patient
Check the problem
Dhwajabhanda, Sukra Dosha,
Klaibya, etc.
Cardiac ability % HTN,
Angina, Block, etc.
Kidney ability % - DM, etc.
Note the Prostrate ability % - secretions
Penile length & lubrications, BPH, oligo
Penile Erection score PES
prostrate
Penile Rigidity score PRS Infections Gonorrhea, HIV, or
Semen Ejaculation score SES any STD
Orgasm score OS Hormones deficiency / over
Androgen deficiency score = activity
Testosterone Medications in use

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Erectile dysfunction or
impotence is a sexual
dysfunction
characterized by the
inability to develop
or maintain an
erection of the
penis.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Ejaculatory dysfunction - Premature


ejaculation is when ejaculation occurs
before the partner achieves orgasm, or a
mutually satisfactory length of time has
passed during intercourse.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Decreased libido
Sexual pain disorders affect women and men
as dyspareunia (painful intercourse). Structural
abnormalities of the penis like Peyronie's
disease can make sexual intercourse difficult.
Orgasm disorders are persistent delays or
absence of orgasm following a normal sexual
excitement phase.
Hormone deficiency is a relatively rare cause of
erectile dysfunction.
Individuals who take drugs to lower blood
pressure, uses antipsychotics, antidepressants,
sedatives, narcotics, antacids or alcohol can
have problems with sexual function and loss of
libido.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Male Infertility
Infertility primarily refers to the biological
inability of a person to contribute
to conception.
Infertility has increased by 4 percent since the
1980s
About 40 percent of the issues involved with
infertility are due to the man
Infertility can be caused by low sperm count
due to endocrine problems, drugs, radiation, or
infection. There may be testicular
malformations, hormone imbalance, or
blockage of the man's duct system.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Benign Prostatic Hypertrophy


BPH is enlargement of the Prostate that is
located in the pelvis and is surrounded by the
rectum, bladder, dorsal and periprostatic
venous complexes, musculature of the pelvic
sidewall, the urethral sphincter (responsible
for passive urinary control), the pelvic plexus,
and cavernous nerves (which innervate the
pelvic organs and corpora cavernosa).
Sushruta and Charaka explained the Sthana of
Basti in the similar fashion.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Uttara Vasti Netra


Male
12 cms (Anguli) resembling jasmine flower stalk, tail of the
cow, hole equal to mustard seed (Charaka)
14 (Anguli) cms (Susruta)
Female
10 cms (Anguli) comfortable size to pass the urethra, hole
equal to Green gram seed
for full grown nulli paras 4 (Anguli) cms
virgins 1 (Anguli) cm [Garbhashaya sodhana should not be
performed in the virgins]
Charaka Siddhi 9/58, 9/72, 9/73-4, Susruta Chikitsa 37/101, 37/103, 37/104-5

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Medicine quantity & Target

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Age Vs Action
Sukra Pravartaka (virechaka) =
Abundant Ejaculatory - at his 20s
Sukra Janaka pravartaka = Productive
& Ejaculatory efficiency at his 30s
Sukra Janaka = semen generative
(procreative efficient) at his 40s
Sukra sthambhaka = Ejaculatory
preventive (sex effective) at 50s
Vaji Karana = Horse powered sex
efficiency even at 50s and 60s
Thinking of sex with flaccid organ at
70s - NO ACTION

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Prakrita Mutra Pramana


The normal quantity of Mutra is 4 Anjali. (Ch. Sha.7)
1 Anjali is nearly about 4 ounces. So 4 Anjali is nearly about
16 ounces, (480 ml) which clearly indicates that Acharyas
considered 4 Anjali only because of the storage capacity of
Basti.
In 24 hours 1500 ml of urine is excreted out which can be
considered. 1500 ml cannot be stored in bladder at normal
physiological instances.
The urinary bladder performs the function of Dharana
(storage) and poshana (release) of urine. The example of a
''taut bow" in relation to Basti signifies the functioning of
the urinary bladder in the light of modem physiology.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Pourusha Vasti Male Uttara Vasti

What happens in this technique?


Former technique followed by Ayurveda
is placing the medicine in to Urinary
Bladder. It is done by a catheter and
syringe.

Present technique passes Urethra


Prostate seminal vesicle vas
deferens and Testicles.
The whole medicine is rapidly
absorbed along with local action of
medicine.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Preparation
Patient
Ask the patient to
evacuate bladder
Instruments
Feed tube size 8-10
10ml syringe
Gloves
Penile clamp
Clamp holder
Antiseptic solution &
gauze
Medicine

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Patra Paka
Heat the empty vessel
To make disinfection
Pour the medicine
10-15 ml of the
selected medicine
Get it cooled
To administer

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Step 1
Wear the gloves
under aseptic
antiseptic
precautions
Retract the
prepuce skin
Expose the urethra

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Step 2
Clean the glans
and surrounded
area with
Antiseptic
solution

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Step 3
Load the syringe
with medicine
Attach it to the
feed tube
Gently push the
syringe to fill the
feed tube where
1 -2 drops of
medicine drops at
the glans

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Step 4
Gently insert feed tube in
urethra
Pass the tube about 10 cms
till to the bladder
sphincter
Make sure that you are not
inside the bladder
Retract the syringe piston - if
you are inside the bladder
urine come in to syringe
If you are giving a Uttara
Vasti in to Bladder it is
confirmatory sign

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Step 5

Pass the clamp around penis and lock with clamp


holder
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Step 6
Gently push the
medicine
Care should be
taken not to
slip the tube
inserted

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Fortified UV Procedure
Closure
Withdraw the tube
Locked clamp will
remain for 45 minutes
After 45 minutes
Release the lock with a
cotton padding placed
at urethra to absorb
the withdrawals

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Influencing factors of Pourusha Vasti


Physical state:
Liquids are better absorbed than solids, and crystalloids are
better absorbed than colloids.
Particle size:
The particle size of sparingly soluble drugs can affect their
absorption. Thus, a compound that contains large aggregates
of the active compound does not disintegrate easily even on
prolonged contact with mucosa hence, is poorly absorbed.
Small particle size is important for absorption. Thus, the
dosage of the active drug can be reduced without losing
efficacy simply by reducing the particle size.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Influencing factors of Pourusha Vasti


Lipid or water solubility: High lipid solubility of
the non-ionised drug form favours its
absorption from the gastrointestinal tract, in
the same way at the rectum and also in urinary
bladder.
Concentration: Higher concentration favours
rapid absorption.
Presence of other agents: Thus vitamin C (Amla
varga) enhances the absorption of iron from
the gastrointestinal tract, while phytates retard
it.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Influencing factors of Pourusha Vasti


Ionization: It may be assumed for all
practical purposes that the mucosal lining of
the bladder is impermeable to the ionized
form of a weak acid or a weak base. The
weakly acidic and basic drugs exist in two
forms. A unionized component,
predominantly lipid soluble, absorbed
rapidly. An ionized and often water-soluble
component absorbed poorly.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Pourusha Vasti Male Uttara Vasti

Influencing factors of Pourusha Vasti


Area of the absorbing surface and local
circulation: Drugs can be absorbed better
from the small intestines than from the
stomach because of the larger surface area
of the former. Reduction in the area of the
absorbing surface, as in Uttara Vasti
prolongs the absorption as it retains for
more time under sphincter control.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Medicines in Practice
Vidaryadi Ghrita

* = More highly significant, n=15


Naik PL & KSR Prasad, MANAGEMENT OF SUKRAGATAVATA WITH VIDARIGHRITA A COMPARATIVE STUDY W.S.R TO
PREMATURE EJACULATION, 2010, RUGHS, Bangalore,

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Medicines in Practice
Narayana Taila & Vidaryadi Ghrita
Parameter Mean SD SEM

Semen count (millions/ml) B 5 7.07 5


A 22 25.45 18
Total sperm count B 12.5 17.67 12.5
(millions) A 72 67.88 47.99
Motile Total sperm count B 2.0 2.82 2.0
(millions/ml) A 5.0 4.24 2.99
Total motile count (millions) B 5.0 7.07 5.0
A 18 8.48 5.99
Motility % B 25 21.21 15
A 60 14.14 10
Study at MGACH&RC in 2012-13 (ongoing)

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Efficacy of Bala- tail Utterbasti in Oligospermia -A


Clinicopathological Study.
More Sunil S. More Manjusha S
International Journal of Ayurvedic and Herbal Medicine 5:4 (2015) 19321940

A open random study with 20ml Bala taila


administered per urethra in to Urinary
bladder once in 3 days for a month for 3
consecutive months

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Patil Rupesh Vilas. Virechana Paschat Shatavari Ghrita Uttara


Vasti in Ksheena Shukra- A Case Study. International Journal of
Ayurveda and Pharma Research. 2016;4(9):29-31.
A male patient presented with inability to beget a child due to
low sperm count (< 10 million/ml) and sperm motility (< 30%)
detected in previous two semen analyses along with reduced
sexual desire and inability to sustain erection.
Snehapaana with Shatavari ghrita, followed by Virechana with
Kalyanaka gudam and later Uttara Vasti with Shatavari Ghrita
administered in 7 sittings after initial administration of 2
Madhutailika Vasti resulted in significant increase in sperm count
(>50 millions/ ml) and motility (>50%).
A significant improvement in sexual desire, sustained erection till
the completion of sexual act was noticed and testicular pain along
with post coital exhaustion was completely relieved.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Pourusha Vasti Male Uttara Vasti

Management of urethral sticture with uttara vasti


Dudhamal et.al., ASL, v30, no2 (2010)pp51-53

A 25 year old male approached with dysuria, slow stream


of urine, incomplete emptyng of bladder leading to
fullness of bladder, increased frequency of micturition and
cystitis.
Aa mixure of 15ml Plain Tila taila, Honey 4 ml, Sandhava
lavana 1gm is used for Uttaravasti in to urethra and
retained for 10 minutes (Author is not clear whether he
pushed the material in to urinary bladder or made only
retained at urethral level)
Patient is comfortable and two more sittings were
undertaken after wards.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Rajendra H Amilkanthawar, Role of uttarbasti in management of


mutra marga sankoch (urethral stricture)
Indian Journal of Traditional Knowledge, Vol. 3(2), April 2004, pp. 177-181

Drug and their proportions


Til Tail (Sesame oil) 100 ml, Saindhav lavan (Rock salt) 04 gm, Madhu
(Honey) 20 ml
Under all aseptic precaution glass syringe is filled with 40 ml of medicated
oil and is taken in right hand and its nozzle is inserted gently into the
external urethral meatus and slight pressure is applied to fix the junction.
Lukewarm medicated oil is inserted with slight pressure and slowly over a
period of 30 second. Care is taken to avoid entry of air into urethra. After
that penile clamp is applied just proximal to glans penis and patients are
kept in situ for 15 minutes. The female patient was advised not to
micturate for next two hours. The procedure was repeated at the interval
of 7 days up to five times in 21 patients, seven times in 08 patients and
eleven times in only 01 patient.

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Rajendra H Amilkanthawar, Role of uttarbasti in management of mutra


marga sankoch (urethral stricture) . ctd

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Conclusion
It is necessary to demarcate Pourusha Vasti
from Mutra marga Uttara Vasti based on its
functions
Ayurveda Suggested 25 to 200 ml of
medicine input for the Mutramarga Uttara
vasti
Concentration, pH, sloubility and particle size
influence the action

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Conclusion
Pourusha Vasti is mainly indicated for BPH and
Azospermia
In one sitting the medicine introduced vary
from 10 -40ml
Both water and lipid soluble medicines can be
administered comfortably
The absorption rate is higher when the
quantity is massive

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Demonstration Stage 1 Preparation

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Demonstration Stage 2 Application

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


Pourusha Vasti Male Uttara Vasti

Demonstration Stage 3 withdrawal

Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/


THANK YOU
27th November 2016
technoayurveda@gmail.com

Its
Technoayurveda
Presentation
By Dr. KSR Prasad, Prof. & Head, Panchakarma,
MGACH&RC, Wardha (MS) . .
http://www.technoayurveda.com/

Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com