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Clinical Trials
Management
of Urethral Stricture by Uttarbasti
:
Up
till now more than 870 patients were treated by this procedure.
No recurrences are observed. The data of 210 patients is
statistically analyzed as below.
Material
and Methods:
Material:
Drugs
– Medicated Oil & Equipments Required
Methods:
Inclusion Criteria :
·
210 Randomly
selected well diagnosed male and female patients of all age
groups.
Exclusion Criteria:
·
With acute urinary
tract infection
·
Diabetic patients
·
With neoplasms of
lower urinary tract
·
With benign
prostatic enlargement
·
With impacted
calculus in urethra and bladder neck.
Observations
:
Parameters
for grading of symptoms and relief of the patients:
Symptoms
of urethral stricture (mutra
marg sankoch) present at first visit were graded and
followed up after each uttarbasti
as
Severe
Moderate
Mild
Complete relief
Symptoms
+++
++
+ _
Table 1: Observations according to
symptoms.
|
Symptoms
|
Total
patients
|
Severe
|
Moderate
|
Mild
|
After
5th Uttarbasti
|
No
response to treatment
|
|
|
|
|
|
|
Complete
relief
|
Slight
relief
|
|
|
Burning
micturition
|
210
|
133
|
70
|
07
|
175
|
35
|
Nil
|
|
Frequency
of micturition
|
203
|
56
|
98
|
49
|
175
|
28
|
Nil
|
|
Straining
at micturition
|
210
|
175
|
35
|
-
|
189
|
21
|
Nil
|
|
Decreased
stream
|
210
|
203
|
07
|
-
|
161
|
49
|
Nil
|
|
Prolonged
micturition
|
210
|
21
|
161
|
28
|
196
|
14
|
Nil
|
|
Haematuria
|
42
|
-
|
14
|
28
|
42
|
-
|
Nil
|
|
Incontinence
of urine
|
63
|
14
|
42
|
07
|
63
|
-
|
Nil
|
|
Strangury
|
168
|
42
|
126
|
-
|
161
|
07
|
Nil
|
|
Retention
of urine
|
07
|
07
|
-
|
-
|
07
|
-
|
Nil
|
Profile of Patients:
Incidences
of urethral stricture in relation with
1. Sex: More common in
males (96.67%) and very less in females (03.33%).
2. Age: Most common in
sexually active persons. 96.67% cases were of age group between
16 and 45 years and least common in children (no case recorded).
Table 2: Age Profile
|
Age
|
No.
of patients
|
|
00-15yrs.
|
00(00.00%)
|
|
16-30yrs.
|
98(46.67%)
|
|
31-45yrs.
|
105(50.00%)
|
|
46-60yrs.
|
07(03.33%)
|
3. Marital status: 70%
cases were married while 30% cases were unmarried
4. Aetiological
factors: 70% of cases had history of exposure to unsafe sexual
intercourse and urethritis was found as cause of stricture. The
incidence was followed by instrumental cause which was 16.67%
(Incidences shown in table 3).
Table 3: Aetiological Factors
|
Sr.
No.
|
Aetiological
factors
|
No.
of patients
|
|
01
|
History
of exposure (post gonorrheal)
|
147(70.00%)
|
|
02
|
Instrumental
(Indwelling catheter)
|
35(16.67%)
|
|
03
|
Traumatic
(Rupture urethra)
|
21(10.00%)
|
|
04
|
Post
surgery (Renal calculi)
|
14(06.67%)
|
|
05
|
Meatal
ulcer
|
07(03.33%)
|
|
06
|
Post
meatectomy
|
07(03.33%)
|
|
07
|
Post
circumcision
|
07(03.33%)
|
5.
Prakruti:
83.33% cases were of vat-kapha
prakruti and 16.66% of vata-pittaj
prakruti
6.
Site of Stricture:
·
Membranous urethra-
119(56.66%)
·
Junctional urethra-
anterior and posterior- 56(26.66%)
·
Prostatic part of
urethra -21(10.00%)
·
Penile urethra-
14(06.66%)
7.
Recurrence: No
recurrence was observed
8.
Number of Uttarbasti
required for complete relief -
Table 4: Number of uttarbasti required for complete relief
|
Number
of uttarbasti
|
No.
of patients (%)
|
|
05
|
147(70.00%)
|
|
07
|
56(26.67%)
|
|
11
|
07(03.33%)
|
Results
and Discussion:
Effect
of the subjective parameters has been shown in table 1. The age
profile of the patients is shown in table 2. Results observed in
this study are encouraging, which are 100% as noted at the end
of maximum 11 uttarbasti (table 4). 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.
The
mode of action of uttarbasti is irrespective of the site and the length of the
stricture and the present study confirms the curative role of uttarbasti
in urethral stricture (mutramarg
sankoch). It shows better results as compare to present common
techniques and could prove a blessing to the patients of
urethral stricture (mutramarg
sankoch).
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