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Uttarbasti – a medicinal oil-based treatment of urethral stricture

What is it?

See: http://urethralstricture-cure-in-ayurved.com/  (Uttarbasti is introduction of Sesame oil + Honey + Rock salt into urethra). Basically a glass syringe 40ml is used for this purpose.

Alternative (see this), “Medicated oil or decoction is introduced into the urinary bladder with the help of a rubber catheter through the urethral opening under aseptic conditions.”

A further ayurvedic doctor uses “disposable feeding tube no. 9“. This post claims that INFANT FEEDING TUBE can be used. [This Hindi blog post also describes its results – but no proof is offered]

Note that the size of a metus is around 0.3 inches (this study).

Video below:

Papers that claim that uttarbasti works:

K. Rajeshwar Reddy’s study

This seems to be a tolerable quality paper: Clinical evaluation of Apamarga-Ksharataila Uttarabasti in the management of urethral stricture

Even though this study is published by a shoddy journal (An international quarterly journal of research in ayurveda), it is featured on the website of the US National Library of Medicine, National Institutes of Health. That doesn’t make it a good study, but perhaps its results can be considered – with a pinch of salt.

In the present study, total 60 patients of urethral stricture were divided into two groups and treated with Uttarabasti (Group A) and urethral dilatation (Group B). The symptoms like obstructed urine flow, straining, dribbling and prolongation of micturation were assessed before and after treatment. The results of the study were significant on all the parameters.

Basically, uttarbasti works in the short term as well as dilation but has SIGNIFICANTLY fewer rates of recurrence.

But note that patients selected for this study had “mild to moderate” stricture. No one had a severe stricture.

Rajendra H Amilkanthwar’s work

Rajendra H Amilkanthwar is probably the most prominent ayurvedic doctor to make this claim. He got a clinical trial approved by the US government in 2007 but DID NOT COMPLETE IT. His claims (which clearly did not qualify the stringent requirements of the US government) are published in a paper: Role of uttarbasti in management of mutra marga sankoch (urethral stricture) – Rajendra H Amilkanthawar

Interestingly, he claims that his research has been uploaded on the US government website, which seems to be false:
The author is working as a assistant professor in the subject of Shalyatantra (Surgery in Ayurveda) from last twenty years in Govt. Ayurvedic Colleges in Maharashtra state. He has previously worked at Nagpur & Osmanabad and currently working at Govt. Ayurved College, Nanded in Maharashtra, India.
He is involved in the field of research since 1992. He is working in the field of urology applying the innovative techniques from Ayurveda – the traditional health science of India. With special interest in Urethral Stricture, he has treated over 1500 patients from India and abroad. He has got immense success with the procedure of Uttarbasti in the condition of urethral stricture. Over 95 % patients have been cured.
Research work was accepted by NISCAIR and published in Indian Journal of Traditional Knowledge (IPC Int.Cl7 : A61K35/78; A61K25/00; A61P13/02; A61P13/00.
The work has been conducted under the scheme of Research Fellowship for Teachers, sponsored by Maharashtra University of Health Science, Nashik. The work has been successfully completed and uploaded on clinical trials.gov, an official website of National Institute of Health of US. [Sanjeev: this claim is false, since no completed work has been uploaded]
Research work presented in MASICON surgeons’ conference and many national and international conferences. [Source]

A further case study:

Case report: “Management of urethral stricture with Uttara Basti”  by Dr. T.S. Dudhamal, Dr. S.K. Gupta, Prof. C. Bhuyan

This one takes a single case and is not robust. It also does not undertake longer term follow up.

Further:

A case study here that is very sketchy, refers to some ayurvedic medicines and has no formal documentation.

Further:

Pre and post procedural urethrography was carried out in all patients. Findings of urethrography revealed increase in the caliber of urethral lumen. Pre and post procedural urine flow rate was recorded. Pre procedural average urine flow rate was 30-50ml/10sec while after completion it improved up to 140-160ml/10sec. No post procedural complications, delayed complications and adverse effects were observed. [Source]

See this.

In this webpage, two self-declared auyurvedic doctors say that uttarbasti can reduce symptoms but won’t cure them. Plus Uttarbasti has HIGH RISK OF INFECTION.

Centres that claim to use this method to treat patients:

http://www.cureurethralstricture.com/uttarbasti.html

Most of the patients require ten sittings which are usually done on alternate days. 

Total duration of treatment is approximately 20 days.

Sunil Kahlekar

A doctor sunil kahalekar cured a patient who reported this on youtube.

This patient wrote a blog post on in which Sunil was cited.


His details.

INJECTING OILS OR OTHER THINGS INTO THE PENIS TIP

Uttarbasti involves injecting oil + honey into the urethtra through the penis tip.

Likewise here is a person who has injected hydrogen peroxide into his penis tip [You’ll need to find a 4 to cc syringe,…a plastic one preferred, so you can easily round off the sharp EDGE of it’s output,..so that when you insert it into your urethra/end of penis or in women the other part. You dilute the 3% Hydro to 1.5% via tap water. From that solution in a small cup, or premixed as 1.5%, in an old Hydrogen Peroxide container.
Draw into your syringe at least 2 CC’s of this 1.5%,…and after urinating inject this amount into your Urethra, up into and past the Prostate, or if  you figure the infection is below, in or above the rostate,..simply feel for what will be instant relief, as the 1.5% starts to bubble away at the infection. Hold the tip of the Syringe SEALED in the end of the Penis/womens part,.. and keep it sealed against the syringe tip, by clamping the end of the penis closed, clsing the emptied end of the syringe as the Urethra plug. Hold this dilute solution of Peroxide in your Urethra for 25 to 35 seconds,..and then removing the plug/syringe, as you will have a sensation of peeing, as part of the infection fluids and 1.5% hydrogen peroxide are expelled. Repeat this twice in the morning”

Further:

There is a claim made by someone (a patent) that a herbal mixture can cure strictures.

Homeopathic treatment

While on this subject, there seems to be some claims on the internet that homeopathy has reduced the need for dilation: https://hubpages.com/health/Homeopathy-Safe-Natural-Cure-For-Urethral-Strictures

  • but a couple of patients admitted it didn’t work; and finally had to undergo the plasty operation.

Aloe vera for urethral stricture

I’ve had superb results with aloe vera and have used it virtually everywhere – including for an anal fissure (which medicine could not cure). I have also applied aloe vera AND honey directly into my eye and it had only a positive effect (although in my case this was unnecessary since the cause was unrelated to the eyes: it had to do with cheek muscles).

Aloe Meatal Catheterhttp://hunterurology.com/products/5-aloe-meatal-catheter– Clearly someone has already got the idea of using aloe vera as a coating for urinary stricture.

Note that there is a medicine alprostadil that is inserted into the meatus: See this (including diagrams). This video shows how it is done.

Overall it is evident that if done safely and with elimination of bacterial contamination, insertion of a small object into the meatus is safe.

 

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Policy issues identified after my experience with prostate surgery

I’ll pursue these after I’m better:

  1. There needs to be an independent body that tracks progress of continence and erectile function of surgeons. [“The NHS – who make surgeons report their success rates these days – regard success after RP as using 1 pad or less per day by 12 months post-op.” – Source]

2. Patients need to be given a copy of the video after robotic prostate surgery. It is clear that doctors get a copy of their surgery video record: “I asked my doctor if he understands why some people have more severe incontinence problems and he said there is some correlation with age and fitness but that he’s reviewed the videos and records from his past surgeries and tried to correlate them with the outcomes but he still doesn’t understand the variations in outcome.” [Source]. This does imply, thought, that providing the video to an untrained patient might not do the patient any good. If even experts can’t use the videos to predict continence outcomes then it is unlikely that giving the videos to the patients will help.

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Useful videos on post-prostate cancer surgery

This is an unorganised list – videos that I found useful.

HOW TO DO A PELVIC FLOOR EXERCISE: Pelvic floor exercise: Suck the nuts into the guts. Make sure the lower abdominal muscles are also squeezed.  Each squeeze and lift needs to be as strong as hard as you can. Squeeze very hard then cough. That makes the muscles work. Do “more, more, more”. Hold for up to 10 seconds. See 27 minutes at:

Live Life Dry – Understanding Male Continence – Dr Vincent Tse – this is a good overall video

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Skin care while wearing pads after prostate surgery

CHANGE FREQUENTLY

“All devices should be changed frequently to avoid odor and skin maceration. Fungal infections can occur.” [Source]

Skin Care: Skin irritation is commonly associated with incontinence. Here are some simple steps to care for your skin:

  • Wash in warm water using a soap free cleanser or pH neutral soap.
  • Pat dry carefully – do not rub.
  • Avoid talcum powder as it can cause skin irritation and may interfere with the absorbency of pads.
  • Wear firm fitting cotton underwear – no boxer shorts.
  • Avoid plastic pants or sheets that will cause you to sweat.

If your skin becomes irritated, you can use sorbolene cream to moisturise the area. A barrier cream may also be necessary. Use any cream sparingly as they may interfere with the absorbency of pads. Talk to a continence nurse advisor if your skin irritation does not improve with these simple steps.

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Notes on SVT, arythmias

It can be hard to diagnose SVT if it is sporadic

Holter monitors are only useful if there is regular or chronic SVT. Cardiac Event Monitors also can only be used for a month, but in my case the event can happen once in a year. See this.  A LOT OF MOBILE ONES ARE NOW AVAILABLE. read this.

CHEAP PORTABLE DEVICES ARE NOW AVAILABLE.

Monitoring for asymptomatic but infrequent arrhythmias. The test may be performed to look for
arrhythmias like atrial fibrillation (AF), or complex ventricular arrhythmias such as ventricular tachycardia (VT). This includes before and after treatments such as drug treatment of AF, to confirm the effectiveness of procedures such as ablation of arrhythmias like atrial fibrillation (AF), atrial flutter or supraventricular tachycardia (SVT) and, less frequently, ventricular tachycardia. [Source]

NEED TO GET CORRECT DIAGNOSIS

One day I awoke and stood up and my heart suddenly started racing for no reason.  I drove to the surgery, walked straight into the nurses quarters and they gave me an ecg straight away.  I was diagnosed then with svt.  Five years later I underwent an ablation and thankfully I appear to be cured.  In your case if they have recorded your heart racing then it would be a simple job to diagnose svt.   [SOURCE]

GO TO EMERGENCY DEPARTMENT

Anyone who suspects he has a heart rhythm problem needs to see a doctor immediately. This is the kind of problem that often should be seen as soon as suspected, in an emergency room. It could be a minor issue, but it could also quickly be life threatening. A good internist, family physician, or emergency medicine physician may even choose to refer you to a cardiologist for an immediate evaluation. [Source]

All arrhythmias should be taken seriously. We categorize them by where in the heart the arrhythmia is occurring. The atria are the upper part of the heart and the ventricles are the larger pump part of the heart in the bottom. Generally, atrial arrhythmias are less of a risk to health compared with ventricular arrhythmias. Untreated atrial arrhythmias can cause blood clots to form in the heart. These clots can break loose and lead to strokes if the clots lodge in the brain. Ventricular arrhythmias can lead to a dramatic decrease in blood flow to the brain and other organs. This can lead to sudden death.

Some arrhythmias are treated with anti-arrhythmic medicines. Some are treated with a pacemaker, which is an instrument that electrically stimulates the heart to beat normally. Some arrhythmias even require an implanted defibrillator that monitors the heart and shocks the heart back to a normal rhythm should a dangerous rhythm develop. In some cases doctors may even do a surgical modification of the electrical system to prevent arrhythmias.

BUT DON’T PANIC

Don’t panic if you’ve occasionally had these symptoms. Arrhythmias are extremely common, especially as you get older. Each year millions of people have them. [Source]

In general, SVT is almost never a life-threatening problem and the episodes do not need to be treated as a medical emergency. If an episode occurs, vagal maneuvers (these are explained in the section below on treatment) should be tried. If the episode lasts longer than 45 minutes the child should be taken (by car without undue haste) to a local emergency room for treatment. [Source]

SVT

Supraventricular tachycardia: Supraventricular tachycardia (SVT) is any arrhythmia that begins above the ventricle. SVTs are usually identified by a burst of rapid heartbeats that can be chronic or begin and end suddenly. These bursts can last a few seconds or several hours and may cause your heart to beat more than 160 times per minute. The most common SVTs include atrial fibrillation and atrial flutter. These bursts can last a few seconds or several hours and may cause your heart to beat more than 160 times per minute. [Source]

How do you know that you don’t have AF (Atrial fibrillation) – if you feel a fluter but your PULSE REMAINS UNCHANGED. [source]

In my case the pulse becomes really quick.

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