Introduction

It is a special treatment modality in Ayurveda where a sterile medicated cotton swab is kept inside the vagina for a specific period. This comes under local treatment modalities specific to gynaecological diseases in females and is also done in antenatal care. Pichu means “cotton ball”. Yoni Pichu is the application of a sterile cotton swab soaked in medicated oil or ghee in the vagina.

Treatment Procedure

The treatment procedure is divided into three parts

1. Purva karma (pre-procedure)
2. Pradhana Karma (main Procedure)
3. Pashchat Karma (Post Procedure)

Purva Karma

Selection of patients:

For female patients in whom the procedure is planned, initially, a routine gynaecological examination is done to rule out any vaginal infections and assess the status of the uterus, its direction, size, etc, and rule out any PID (pelvic inflammatory disease). If signs of PID are found then the procedure is held until the infection is under control.

Selection of the medicine:

Depending on the condition of the patient, medicated decoctions, oil, or ghee are selected based on the assessment by a qualified physician.

Pradhana Karma

Preparation of the patient:

If the patient is found fit for the procedure, she is asked to empty the bladder and to lie in the lithotomy position on the examination table. Private parts are cleaned antiseptically. Under aseptic precautions, the sterilized cotton ball is covered with a sterile gauze piece and a tail is made using the gauze so that it can be removed by the patient herself at the end of the procedure. The sterile cotton ball is soaked in the desired medicine which is made lukewarm and introduced vaginally under aseptic precautions.

Pashchat Karma

After the procedure, she is asked to lie in the supine position for ten minutes and is then allowed to leave. The Pichu is retained for 1 hour or till she has a sensation of micturition when it is removed by pulling the gauze tail after sitting in a squatting position.

Indications

Gynecological

1st and 2 nd -degree uterine prolapse
Cystocele (bladder prolapse)
Rectocele (rectal prolapse)
Post-menopausal vaginal dryness
Dyspareunia (painful coitus)
In certain types of recurrent miscarriage

Obstetrical

In the ninth month of pregnancy for promoting laxity of the pelvic floor muscles to enable normal labour.
During labour in the retained placenta, medicated Pichu which is capable of making uterine contractions is used.
In post-operative management of obstructed labour to correct the damage done to the pelvic tissues.

Mode of Action

Pichu helps the medicine to remain at the site for a longer period for better action.
The mode of action depends on the medicine used, as different medicines have different modes of action.
The sesame oil base is most commonly used and it has high antiseptic and antibacterial properties.
The Pichu used during pregnancy and labour helps to soften the vaginal canal enabling easy delivery and easy expulsion of the placenta.

Yoni Pichu