Volume - 12 | Issue - 08 | August - 2022 | PRINT ISSN No. 2249 - 555X | DOI : 10.

36106/ijar
Original Research Paper
Ayurveda

UTTARBASTI: A TRADITIONAL APPROACH IN THE MANAGEMENT OF

MOOTRAGHATA (BENIGN PROSTATE HYPERPLASIA)-A SINGLE CASE
STUDY

Phd Scholar, department of shalyatantra, institute of teaching and research in Ayurveda,

Dr Neeraj Kumar* Jamnagar, Gujrat, india.*Corresponding Author
Associate professor and I/C hod, department of shalyatantra, institute of teaching and
Dr T. S Dudhamal research in Ayurveda, Jamnagar, Gujrat, india.
ABSTRACT Mootraghata or Bladder outlet obstruction (BOO) is the commonest clinical entity in male population after the age of 40
years worldwide. Benign prostate hyperplasia (BPH) has high number of incidences out from various aetiology of bladder
outlet obstruction (BOO). In present case study patient has both cardinal symptoms of BPH i.e, Obstructive- weak stream, intermittency and
Irritative – high frequency, urgency and nocturia with sexual dysfunction. Per rectal examination and ultrasonography conrm the diagnosis for
benign prostate hyperplasia. Uttarbasti (per urethra) is one of the treatment modalities in the management of Mootraghata or various
mootravikara. In present case study 20 cc balataila uttarbasti once in day for two weeks in month at one week interval with kanchanar guggulu one
gram three times in day for one month has been given to patient for one month. Patient has relief in subjective symptoms as well as in objective
ndings.
KEYWORDS : Balataila, BOO, BPH, Mootraghata, Uttarbasti
Introduction Kanchanar Orally 1 gm three One month
Mootraghata is one of the diseases of Basti region or Mootrasansthan guggule times in day
(Urinary system)1. Basti is known as one of the seat of three maha with water
marma (Most important)2. As per all acharyas the disease occurred Uttarbasti- with informed consent patient was given in supine position.
over marma place is naturally having bad prognosis or difcult to With proper aseptic measures painting with povidone iodine and
cure3. BOO (bladder outlet obstruction) mostly develops in the elder draping done. Twenty cc of 2% xylocaine jelly pushed into urethra. A
age male due to prevalence of BPH in old people4. Old age people are ten no. feeding tube inserted into urethra about twenty centimetre and
unable to do routine activities properly due to physiological and twenty ml of sterilized balataila pushed slowly. The feeding tube
anatomical age-related changes in the body. Due to irritative and withdrawal gently and glans penis covered with sterilized gauze piece
obstructive symptoms, benign prostate hyperplasia makes condition and Penile clamp was applied for 15 minute after withdrawal of
worse in these people. Sexual dysfunctions are associated with the feeding tube.
condition of benign prostate hyperplasia5. All acharyas advocated the
Uttarbasti is the prime treatment option in management of Assessment criteria
mootrasanstha vikara (Urinary system disease)6. Patient assessment was done with proper method and protocol given in
previous study as
Many of treatment modalities or research work done on the treatment
of mootraghata (benign prostate hyperplasia). In almost all study Subjective criteria
patient was older age or above fty year7. In old age physiological and Ÿ International prostate symptom score (IPSS)9
anatomical changes are the hurdle in taking medicine or intervention Ÿ Male sexual function score (MSFS)10
and changes are responsible for slowing or delaying effect of Ÿ International index erectile function score (IIEFS)11
medicine8.
Objective criteria
In this case study patient was forty ve year of age. Patient was Ÿ Ultrasonography- Prostate size and post voidal residual urine
physiologically and anatomical t for intervention and medicine are (PVRU)
effective in earlier old age also. Ÿ Uroowmetary

Patient information Clinical findings

A 45 years male patient presented in OPD of shalya tantra having Table no. 2 Per rectal examination
following symptoms.
P/R Findings
Patient having frequency of urine, urgency and hesitancy since one Enlargement of lobes Right lateral/Left lateral
year. Shape of prostate Oval
Dribbling of urine and straining since three months Surface Smooth
Patient has no any past medical and surgical history. Upper border Reached
Median groove Palpable
Past intervention Mobility Movable
Patient taking Tamsulosin hydrochloride 0.4 mg once per day for 3
months from government hospital, but symptoms were static. Patient Rectal mucosa Free
did not have relief so he comes in Ayurveda OPD for further advice and Consistency Soft
management. Tenderness Absent
Size of prostate Moderate
Methodology
Intervention Before treatment clinical assessment
Subjective criteria by scoring pattern:
Table no 1-Two forms of pharmacological Ayurveda formulation Ÿ Assessment was done with proper application and method using
were used as treatment drugs. IPSS score according to available previous study, 23 out of 36 was
a total score of IPSS score in this patient. Quality of life score fall
Drugs Route of Dose Duration in mostly dissatised attitude. Total scoring showed severely
administration symptomatic.
Balataila Uttarbasti 20 cc once in For two week at one Ÿ Male sexual function score was eight out of twenty. Assessment
day week interval was done with proper application and method using male sexual
INDIAN JOURNAL OF APPLIED RESEARCH 1
 Volume - 12 | Issue - 08 | August - 2022 | PRINT ISSN No. 2249 - 555X | DOI : 10.36106/ijar
function score as per available previous study. 2. When you had erections with sexual 4 4
Ÿ International index of erectile function score was Nineteen out of stimulation, how often were your erection s hard
twenty ve. Assessment was done by using IIEF score as per enough for penetration?
available previous study. 3. During sexual intercourse, how often were you 4 4
able to maintain your erection after you had
Table no. 3 Time line as per case report guidelines12 penetrated (entered) your partner?
4. During Sexual intercourse, how difcult was it 4 4
to maintain your erection to completion of
Intercourse?
5. When you attempted sexual intercourse, how 3 5
often was it satisfactory for you?
Total score 19 21
Table no 8 showing difference between before and after treatment
result on IIEFS male sexual function score. Patient nding changes
from 19 to 21 after treatment.

Table no. 9 Comparative assessment of before and after treatment

findings of USG
BT AT
Prostate size 43 x 52 x 50 25 x 24 x 32
Prostate volume 55 cc 32cc
PVRU 60 ml 25 ml
Table no. 9 shows changes before and after treatment ndings of
ultrasonography and PVRU. Prostate size changes from moderate mild
size. Post voidal residual urine volume changes to non-signicant
range.
Objective Criteria:
After treatment clinical assessment Table no. 10 Comparative assessment of Uroflowmetary before
Subjective criteria by scoring pattern: and after treatment
Ÿ 10 out of 36 was a total score of IPSS ndings in this patient. Findings BT AT Findings BT AT
Quality of life score fall in mostly satised. Total scoring showed Voided volume 107 ml 180 ml Flow time 24 sec 42 sec
moderately symptomatic.
Ÿ Male sexual function score was eight out of 20. Max ow rate 09 ml 14 ml Delay time 00 sec 00 sec
Ÿ International index of erectile function score was 21 out of twenty
ve. Average ow rate 02.6 ml 5.03ml Interval time 11 sec 4 sec
Voided time 40 sec 46 sec Time to max 38 sec 32 sec
Result assessment ow
Table no. 6 comparative result of before treatment and after Table no 10 showing difference in uroowmetary on given ndings.
treatment of IPSS findings
S no. Findings BT AT Table no 11. Intervention tolerability (Assessed by the patient
1 Incomplete emptying 4 2 observation by himself)
2 Frequency: 5 2 Day 1 20 min Day 2 15 min
3 Intermittency: 3 1 Day 3 1 hour Day 4 1hour
4 Urgency 3 1 Day 5 40 min Day 6 45 min
5 Weak stream 2 2 Day 7 1 hour
6 Straining 3 1
Patient was asked to hold or retain given balataila uttarbasti as much as
7 Nocturia: 3 1
possible. Table no. 11 showed day per day holding capacity. No any
Total score 23 10 unwanted sign and symptoms addressed by the patient.
Table no. 6 showing ndings of IPSS score before treatment and after
treatment. Changes in total score showing severally symptomatic Discussion: IPSS score are divided in irritative and obstructive
prostate has relief to moderate symptoms of prostate. symptoms, Obstruction due increase size of prostate pressure excreted
on bladder and urethra as well irritative symptoms develop due to
Table no.7 comparative result of before treatment and after congestion of mucosa and infection cause by retention of urine.13
treatment of Male sexual function score Sexual organ of human being has common development and related
Findings BT AT through physiologically and anatomically with urinary system14. The
prostate is a common organ in anatomy and physiology of Sexual and
1.Your interest in sex 4 2 urinary system15. In Ayurveda basti is called a seat of vata dosha16.
2.Quantity of your erection 3 2 Vitiated vata dosha associated with other dosha's are responsible for
3.Achieving orgasm 3 2 various disease of basti17. All acharya advocated uttarbasti is a best
4.Achieving ejaculation 3 2 treatment modality in the case of mootrvaha sansthan roga. Balataila is
a compound drug made by tila tail (Sesame oil) and atibala herb
Total score 13 08
(Abutilon indicum linn). Tila taila has vata-kafa shamak ( Tailam
Table no 7 showing difference between before and after treatment vatasleshma prashmanam shrestham)18 produce soothing and
result on male sexual function score. Patient nding changes to 13 to relaxant effect on bladder and urethra wall. It soften tissue, increase
eight after treatment. elasticity, penetrates up to deep tissue and promotes regeneration18.
Sesame oil also has vyavayi (fast in digestion), sukshma (micro) and
Table no 8 Comparative before and after treatment findings of snigdha (lubricant), which are helps in dilatation of urethra and bladder
International index of Erectile Function Score wall18. Atibala has balya (rejuvenating), bhrungan (nutritive), sothhar
Findings BT AT (anti-inammatory) and mootral (diuretric), properties, therefore
baltataila has compound properties of anti inammatary, diuretic,
Over the Past six months 4 4
rejuvenating and act as nerve tonic.18 Atibala also have anti-
1. How do you rate your condence that you
oestrogenic property which has effect on pathogenesis of benign
would get and keep an erection?
prostate hyperplasia directly and promote sexual function in male
2 INDIAN JOURNAL OF APPLIED RESEARCH
 Volume - 12 | Issue - 08 | August - 2022 | PRINT ISSN No. 2249 - 555X | DOI : 10.36106/ijar
people.19 Kanchanaar guggulu having anti-inammatory, anti-
cholinergic, scrapping, aphrodisiac stimulant, anti-spasmodic, muscle
relaxant and effective in urinary disorder20. These properties of drugs
are helpful in treat mootraghata with the direct application of drugs to
prostate tissue via uttarbasti .

Uttarbasti is a useful route for direct application of medicine in BPH

condition and also may useful case of contradiction of other route i.e;
acute ssure in ano for anal route or GIT diseases for oral medicine.

Conclusion
The result obtain in this single case study advocate that balataila
uttarbasti with kanchanar guggulu having better result on the
mootraghata sign and symptoms.
Acknowledgement: Director, ITRA, Jamnagar

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