A Clinico Comparative Study Of Shwadamstradi Taila Uttarbasti With And Without Matrabasti In The Management Of Mutrakruccha With Special Reference To Urethral Stricture An Open Label Randomized Comparative Clinical Trial

Stricture urethra though a rare condition still is a rational and troublesome problem in the international society. There is marked increase in incidence starting at the age of 55 years. Studies have suggested that men appear to be at more risk than that of females as they have longer urethra. Worldwide it is estimated that male urethral strictures have a prevalence of The etiology of urethral strictures is divided into 4 major groups Idiopathic Iatrogenic inflammatory and Post traumatic. Urethral stricture may present in the of range of manifestations from an asymptomatic presentation to severe discomfort secondary to urinary retention .It is common condition resulting in many office appointments emergency room visits and hospital admissions with the estimated rate around 1 to 9 strictures per 1000 people in India.

Stricture usually arising from prolonged catheterization radiation BPH prostatic and trans urethral surgery repeated UTI and STD.  Approximately 30 percent of urethral strictures are idiopathic and most common causes of urethral stricture today are traumatic or iatrogenic. Iatrogenic urethral trauma usually results from improper or prolonged catheterization and accounts for 32 percent of strictures. Some patients may choose to manage their stricture disease with periodic urethral dilations. The goal is to stretch the scar without producing additional scarring. It may be curative in patients with isolated epithelial strictures means no involvement of corpus spongiosum. Most of the time urethral stricture is seen in elderly population with a marked increase after 55years of age. Urethral stricture disease is still a prevalent problem with an estimated incidence of 0.6 percent in susceptible population. In patients with urethral stricture disease older than 60 years 6.5percent  underwent retrograde urethrography RUG studies. Urethral dilation remains a very common outpatient procedure among Medicare beneficiaries. Patients with urethral stricture are considered a vulnerable population as they experienced high rates of UTIs and incontinence  as sequelae of the disease. In modern surgery effective therapy has been establish for the condition but more recurrences and complications. The discussion on surgical techniques and diagnostic methods of one of the oldest pathologies known to the urologist is still continuous. Thus  the urethral stricture remains a challenging pathology today. Hence there is need to find other treatment option for Urethral stricture. Acharya sushruta mentioned Ghrita and Taila Uttarbasti in management of the Urethral stricture.  In Uttarbasti Drug reduce the fibrosis in stricture part of urethra. Matrabasti Drug pacifies the pain particularly at the perineal region as the Mutravaha Srotasa become free from vitiated Vata. By keeping mentioned things at point of convergence shwadamstradi taila Uttarbasti with and without Matrabasti is selected for the management of Mutrakruccha with special reference to urethral stricture. Though there are multi folded treatment modalities exists in western medical science they are having own advantages and disadvantages so there was an intense and persistant scope to find out simple and easily available treatments for relieving painful micturition by increasing constricted urethral lumen diameter without any adverse effect. Uttarabasti a para surgical procedure is the most effective available treatment in Ayurveda for the diseases of Mutravaha Strotas. In Mutrakruccha there is vitiation of Vata especially Apan vayu which is located at Shroni Basti  Medhra leads to obstruction of urine outflow due to this Vimargagamana and Marga Avrodhan occurs. Therefore

main principle should be to Vatanuloman and Mutrashodhan to return the normal qualities of Apan Vayu. Medicated oil prepared out of Gokshur swarasa Gud Kshir Shunthi which are prepared by Tailapak method.Due to this Sanga gets removed from Mutravaha Strotasa particularly at the urethra leading to increase in size of the lumen which was constricted previously diameter at the site of stricture. As the Mutravaha Strots become free from the vitiated Vata. considering all the views Shwadamstradi taila

Uttarbasti with and without Matrabasti has been selected for the management of Mutrakruccha with special reference  to Urethral Stricture.