Uttarabasti in bladder neck contracture following transurethral resection of prostate: A case report

Bladder neck contracture is a common complication of the TURP. Traumatic inflictions may lead to the formation of scar tissue around the bladder neck which makes this tubular structure narrower than the normal. It causes urinary flow obstruction associated with pain, heaviness, hesitancy and incomplete bladder emptying. In Ayurveda, such features have been described under the context of Vatakundalika and Mutrotsanga under the chapter 58 named ‘Mutraghata Pratishedha Adhyaya'of Uttar Tanta of Sushruta Samhita. Bladder neck resection surgery is considered as the surgical treatment in this case but the recurrence rate is high. In Ayurvedic texts, Uttarabasti has been indicated in the treatment of various urinary disorders. A 70-year-old male patient visited the Outdoor Patient Department (OPD) of hospital of National Institute of Ayurveda (NIA), Jaipur, Rajasthan, India; with chief complaints of difficulty in micturition, pain during micturition along with poor stream of urine for the last 2.5 years. He had past history of surgical intervention of Transurethral resection of prostate (TURP) for prostatomegaly and transurethral incision of bladder neck (TUI-BN) of bladder neck contracture. This was diagnosed as a case of recurrent urinary bladder neck contracture and was managed with Uttarabasti of Bala-Ashwagandhadi Taila and oral Ayurvedic medicines with encouraging results. Ayurveda may prove helpful in such type of recurrent and recalcitrant cases and the intervention of Uttarabasti Karma is specifically indicated for the same.