It is a special treatment modality in Ayurveda where sterile medicated cotton swab is kept inside the vagina for a specific period of time. This comes under local treatment modalities specific to gynaecological diseases in females and is also done in ante natal 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 in to three parts
1.Purva karma(pre procedure)
2.Pradhana Karma(main Procedure)
3.Pashcat 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 to assess the status of uterus,it direction,size etc and to rule out any or PID (pelvic inflammatory disease). If signs of PID are found then the procedure is with 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 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 luke warm and introduced vaginally under aseptic precautions.
PASCHAT KARMA
After the procedure she is asked to lie in 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 squatting position.
 
INDICATIONS
Gynaecological

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

Obstetrical

• In ninth month of pregnancy for promoting laxity of the pelvic floor muscles to enable normal labour.
• During labour in retained placenta, medicated pichu which is capable of making uterine contractions are 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 mode of action.
• The sesame oil base is most commonly used and it has high antiseptic and antibacterial property.
• The pichu used during pregnancy and labour helps to soften the vaginal canal enaqbling easy delivery and easy expulsion of placenta.