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    Urinary impediment: Causes, Types, Symptoms, Ayurvedic Treatment

    By Dr MS Krishnamurthy and Dr Raghuram YS.
    One symptom may be found in many diseases. For the patient, that symptom gives discomfort. But for a physician each and every symptom is necesary to understand the patho-pysiology (origin of the disease) and to exactly diagnose the case.
    Dysuria ̵ dificulty in urination (mutrakrichara) and urinary hurdle (mutraghata) are two such disease entities, where ‘dificulty in urination’ is the comon feature.
    Many a times, many diseases may acquire the same causative factors. But, based upon the nature of the individual, season of afliction, suporting fod and habits, individual’s susceptibility and severity of the functional (often structural) entities, these two kinds of diseases are manifested.

    Comon causative factors of the disease urinary tract hurdle, its clinical features, disease clasifications, probable line of treatment and comon Ayurvedic remedies are discused here below-
    Obstructed urine (Mutraghata) is a diseased condition where ‘retention of urine’ is the cardinal feature, whereas in dysuria (mutrakrichara), dificulty in micturition is the simple characteristic feature. obstruction and hence retention of urine may be caused by oclusion of the urinary tract or inflamation in the urinary pathway. Often injury, constriction / compresed stones or any other posible foreign bodies may result in this pathological condition.
    Table of Contents
    Urinary hurdle causes
    Origin of Retention of urine
    Comon clinical features
    Clasification of urine obstruction

    1. Vata kundalika
    2. Ashtela (Vatashtela)
    3. Vata basti
    4. Mutrateta
    5. Mutra jatara
    6. Mutrotsanga
    7. Mutrakshaya
    8. Mutragranthi
    9. Mutrashukra
    10. Ushna Vata
    1. Mutrasada
    12. Vidvighata
    13. Basti kundala
    General line of treatment of obstructed urine
    Single drugs useful in urinary retention / obstruction
    Ayurvedic formulations
    Wholesome diet in obstructed urine
    Unwholesome diet in obstructed urine
    Urinary hurdle causes
    1. Vegadharana (supresion of natural urges)- Read a related article
    2. Roksha ahara (intake of dry fod and les intake of water) ̵ Roksha means dry, Ahara means fod.
    3. Sroto rodha (obstruction to the urinary tract due to stones, gravel, foreign body etc). Sroto means body chanel, rodha means obstruction.
    Origin of Retention of urine
    Due to the above said causative factors the Doshas get agravated. It is predominantly Vata Dosha. The vitiated Doshas mix up with (samsarga) urine and hence prevent the flow of urine. Here, due to the influence over Apana vata, cited at Basti pradesha (blader) the pathology continues and the urinary retention is caused.
    Comon clinical features
    Here, one can find several posibilities love interupted flow of urine, complete hurdle of the urinary tract, non production of urine, redu ced or incomplete production of urine, incomplete or complete excretion of urine etc.
    Clasification of urine obstruction
    Based upon the clinical features, Ayurvedic text boks recount 3 kinds of urinary obstruction.
    1. Vata kundalika
    Due to dry fod, les intake of water or supresion of natural urges, Vata dosha is vitiated and it is lodged in the blader. As it vitiates urine, it is retrograded (kundalikrita) and drive the urine in interupted maner.
    It is comon in the people who work in night shift and in those who take junk and spicy fod excesively.
    Roukshyat vega vighatad va vayuhu vastau sa vedanaha
    Motram avishya charati vigunaha kundale krutaha
    Motram alpa alpam athava sa rujam sampravartate
    Kundalikam tam tu vyadhim vidhyat sudarunam (Ref – Sushruta Utara 58)
    The vata geting vitiated in the urinary blader due to excesive consumption of dry fods and witholding the natural urges / reflexes of the body causes impediment to the pasage of urine and causes a condition caled Vatakundalika.
    Its symptoms are:
    Pain in the blader
    Dysuria and scanty urination
    Retention of urine
    This disease is said to be efortful) to treat
    2. Ashtela (Vatashtela)
    Specific causes agravate Vata dosha and hence obstruct the urinary pathway by distending the blader and rectum. This causes harsh damage during urination as wel as defecation.
    This is comon in the people who are aged to a sedentary lifestyle.
    Aadhmapayan vastim gudam rudhdhwa vayuhu chala unatam
    Kuryat tevra artihi ashthelam motra vin marga rodhinem
    The Vata vitiated in the urinary blader causes distension in the blader and anus. In the proces, the vayu produces a mas which resembles a stone. This mas causes impediment to the pasage of urine and stols. This disease is caled Ashtela.
    3. Vata basti
    Due to constant supresion of urinary urge (due to various personal factors), agravated Vata obstructs the urethral orifice of the urinary blader. Thus, it inhibits the excretion mechanism of urine. This leads to shalow or ful retention of urine in the blader. Ultimately it causes pain in the abdomen and supra pubic (lower abdomen) space. Often itching or iritation may be also asociated as there is relaxation of muscular coat and contraction of sphincters.
    It is very comon in working women, executives and people who travel for long.
    Vegam vidharayet yaha tu motrasya akushalo naraha
    Nirunadhi mukh am tasya vastehe vasti gato anilaha
    Motra sango bhavet tena vasti kukshi nipeditaha
    Vata vastihi sa vijneyo vyadhihi kruchra prasadhanaha (Ref – Sushruta Utara 58)
    The vayu agravated in the urinary blader due to supresion or witholding of urine, blocks the exit route of the urine. This condition is caled Vatavasti.
    Its symptoms are:
    Obstruction to the pasage of urine (retention)
    Pain in the blader
    Pain in the flanks and abdomen
    This condition is said to be dificult to treat
    4. Mutrateta
    Witholding (supresion) the urinary urge for longer duration or post pone of the hury results in gradual (slow) excretion of urine when one goes for urination. This is caled mutrateta. In this condition often aflict may complain pasing dinky by puny urine. This is usualy caused due to fatigue of the muscles and sphincters d ue to constant witholding of urine.
    This is comon in women, drivers, executive oficers, managers and those with high profesion who are engaged due to their work schedule.
    Chiram dharayato motram tvaraya na pravartate
    Mehamanasya mandam va motratetaha sa uchyate
    When we withold the urine for a longer time, the urine does not advance out in one flow when we urinate. Rather, it comes very slowly, in bits and parcels. This condition is caled Murtateta.
    5. Mutra jatara
    Constant supresion of urinary hasten leads to back presure and hence the blader is distended. Further, vitiated Apana Vata ocupies the whole blader and nearby organs and causes severe distension due to exerted presure. Thus, it creates excruciating aflict in the lower portion of the blader. Often gaseous distension of abdomen and constipation are also asociated. When the individual goe s for urination, large amount of urine is pased with dificulty in prolonged time period. It is comon in schol children, security guards and oficers, acountants, bank employes, painters etc.
    Motrasya vege abhihate tad udavarta hetukaha
    Apanaha kupito vayuhu udaram porayed bhrusham
    Nabhehe adhastad adhmanam janayet tevra vedanam
    Tat motra jatharam vidhyat adho vasti nirodhanam (Ref – Sushruta Utara 58)
    Due to the habit of witholding the hury to urination, the Apana Vayu located in the urinary blader gets vitiated and starts moving in a reverse or retrograde direction (upward). This condition is caled Mutrajathara.
    Its symptoms are:
    Distension of the abdomen
    Severe distension with distres below the navel
    Obstruction to the pasage of urine
    6. Mutrotsanga
    When the urine is obstructed in the blader or urethra for longer duration, due to numerous factors (functional or structural), there wil be hematuria (blod with urine). Or else dinky urine is pased with dificulty (dribling) or with distres. Such a condition is known as Mutrotsanga. impediment due to foreign bodies or urinary stones may also lead to such a condition.
    This is comonly witnesed in patients with long standing diseases of urogenital system adore urinary calculi, recto-vesicle fistula, chronic kidney disorders etc.
    Vastau va api athava nale manau va yasya dehinaha
    Motram pravrutam sanjate sa raktam va pravahataha
    Sravet shanaihi alpa alpam sa rujam va atha nerujam
    Viguna anilajo vyadhihi sa motra utsanga sangnitaha (Ref – Sushruta Utara 58)
    When the Vayu gets vitiated in the urinary blader, it causes a condition caled Mutrotsanga.
    Its symptoms are:
    The urine, on its way out gets stagnated in the urinary blader, penis and the glans penis
    If presure is aplied to bring out the urine, it comes out mixed with blod
    Urination takes establish slowly, in les quantity (scanty) with or without pain
    Dysuria
    7. Mutrakshaya
    In the individuals who are physicaly tired, those who sufer from dehydration (primary or secondary), the agravated Vata and Pita Doshas ocupy the blader. Due to this, the quantity of output of urine is reduced and hence aflict and burning sensation are asociated with the main complaint of dysuria. This condition is caled Mutrakshaya in Ayurvedic clasics. Kshaya means decrease. Mutra means urine.
    This is comon in the labourers who work come fire and in chemical factories, mines etc.
    Rokshasya klanta dehasya vastisthau pita marutau|
    Motra kshayam sa ruk daham janayetam tad ahvayam (Ref – Sushruta Utara 58)
    The vitiated Pita and Vata located in the urinary blader of a person who is debilitated due to diseases cause a disease caled Mutrakshaya.
    Its symptoms are:
    Scanty urination
    Dysuria
    Burning sensation
    This condition can be compared with anuria or supresion of urine or cuning nephritis.
    8. Mutragranthi
    Due to the respective factors rakta (blod), vata and kapha are vitiated and they are lodged in the urethral orifice causing a cystic or nodular growth. Due to this, the person pases the urine with much dificulty. The patient wil fel excruciating pain similar to the pain caused during urinary calculi. The condition is known as Mutra granthi.
    This is comonly witnesed in bed riden patients.
    Antaha vasti mukhe vrutaha sthiraha alpaha sahasa bhavet
    Ashmare tulya rug granthihi motra granthihi sa uchyate (Ref – Ashtanga Hridaya Nidana)
    A smal, rounded and firm cyst adore structure resembling a stone geting manifested within the urinary blader is caled Mutragranthi.
    Symptom: Dysuria
    This condition can be compared to enlarged prostate or prostatitis.
    9. Mutrashukra
    Shukra means semen. The person who indulges in sex, while he is having the urge of urination, wil ejaculate the semen mixed with urine or excretes the urine before or after seminal ejaculation. In this condition, the semen apears estem ash disolved in urine.
    This disease condition is found only in men and in those who have strict sexual hasten and unplaned sexual indulgence.
    Motritasya striyam yato vayuna shukram udatam
    Sthanat chyutam motrayataha prak paschad va pravartate
    Bhasma udaka pratekasham motra shukram tad uchyate (Ref – Ashtanga Hridaya Nidana)
    When a person has sexual intercourse with a woman in the presence of urinary urge or r eflex, his Vayu gets vitiated and causes Mutrashukra.
    Its symptoms are:
    The semen propeled from its site and not yet ben ejaculated gets obstructed by this vitiated Vayu and gets discharged either before or after urination
    Colour of the urine – similar to lime water.
    10. Ushna Vata
    Heavy exercise, long walk under extreme sunlight cause the agravation of pita and vata dosha. The agravated doshas are lodged in the urinary pathway. There, it causes inflamation in the nearby areas ̵ blader, urethra, rectum etc. This leads to yelowish urine or blod mixed urine. In this condition, the individual pases urine with dificulty (dysuria) and very frequently. stern pain is also asociated. It is observed in outdor workers, labourers, sports persons etc.
    Vyayam adhva atapaihi pitam vastim prapya anilanvitam
    Vastim medhram gu dam cha eva pradahet sravayet adhaha
    Motram haridram athava sa raktam raktam eva cha
    Kruchrat punaha punaha jantoho ushnavatam bruvanti tam (Ref – Sushruta Utara 58)
    Due to excesive exercise and exertion, walking long distances and exposure to heat of sun, the Vayu vitiated along with Pita gets lodged in the Vasti (blader) and causes Ushnavata.
    Its symptoms are:
    Burning sensation in the urinary blader, penis, anus
    Dysuria
    Colour of urine wil be of turmeric colour, blod stained or blod mixed.
    1. Mutrasada
    Vitiated pita and kapha doshas together gets lodged in the urinary blader. There, the urine is concentrated and consolidated by Vata dosha. It produces redish yelow (hematuria) urine which is often asociated with solids (cast cels). Burning sensation, dysuria and itching are also asociated in this condition.It is comon in the patients with chronic renal failure or dehydration conditions.
    Pitam kapho dwau api va samhanyete anilena chet
    Kruchrat motram tada petam shvetam raktam ghanam srujet
    Sa daham rochana shankha varnam bhavet tu tat
    Shushkam samasta varnam va motra sadam vadanti tam (Ref – Ashtanga Hridaya Nidana)
    Mutrasada is a condition in which pita and kapha ̵ either individualy or together gets dried and solidified due to the afliction of vitiated Vayu.
    Its symptoms are:
    Dysuria
    Burning sensation
    Colour of the urine: yelow, white, red or wil gain the colours of al the Doshas
    Consistency of the urine: Thick
    Apears love the colour of: Gorochana (Bile of the cow) or Shanka churna (Conch powder)
    12. Vidvighata
    Vit means faeces, Vighata means obstruction.
    In the individuals with dry nature ( vata prakriti) and who are debilitated, often vata agravates and the stols are derived upwards (retrograded). Meanwhile, vitiated Vata moves through the urinary tract and enters the blader. Due to this, the individual excretes urine with the smel of stols. Dificulty in micturition is asociated with mild pain.
    It is found as surgical complication in few of the surgeries related to the abdominal organs or uro- genital system.
    Roksha durbalayoho vatena udavrutaM shakrut yada
    Motra sroto anupadhyeta vit samsrushtam tada naraha
    Vid vgandham motrayet kruchrat vid vighatam vinirdishet (Ref – Ashtanga Hrudaya Nidana)
    When the vitiated Vayu caries the stols of an emaciated or feble person in a reverse (retrograde) direction and reaches the urinary blader, the person sufers from a disease caled Vidvighata.
    Its symptoms are:
    Pasing of urine mixed with faeces
    Pasing of urine having smel of faeces
    Dysuria
    This condition can b e compared to Recto-vesical fistula
    13. Basti kundala
    Long traveling or heavy prompt walk, jumping, faling, physical exertions, injury etc may cause the afection / prolapse of the urinary blader. Due to this, the blader wil bulge and atain upward protrusion. This causes harsh pain, pulsation, burning sensation and anxiety. This ultimately leads to interupted urine, hurt and stifnes, cramps, distres in the lower abdomen (supra pubic area), heavines etc.
    This is comon in acidental injuries, sports injuries, wrestling, stampede etc.
    Drutam adhwa langhanam ayasaihi abhighatat prapedanat
    Sva sthanat vastihi udvrutaha stholaha tishtati garbhavat
    Shola spandana daha arto bindum bindum sravati api
    Peditaha tu srujet dharam samstambho udveshtanam artiman
    Vasti kundalam ahuhu tam ghoram shastra visha upamam
    Pavana prabalam prayo durnivaram a budhibhihi (Ref – Sushruta Utara 58)
    The Basti (urinary blader) wil get displaced from its place in an upward direction or wil get inverted and starts loking love a foetus when the below said are done on a regular practise
    Brisk walking
    Jumping
    Exertion exercises or activities
    Or due to injury or presure
    Such a blader presents the below said symptoms:
    Pain
    Fluctuation
    Burning
    Dribling of urine
    Urine comes out in stream when the blader is presed
    Stifnes of the body
    Cramps
    This disease is caled Vastikundala.
    This is a risky disease. It is harmful estem a ken instrument or poison. Vayu predominantly causes this condition and it is augean to treat.
    General line of treatment of obstructed urine
    The general line of treatment of urinary hurdle comprise s oleation (snehana), sweating therapy (swedana), oleaginous purgation (snigdha virechana), enema (basti) and urethral enema (utara basti). Among the oral medications, priority is given for sothing, colant, swet and unctuous- diuretic (mutrala) substances.
    Single drugs useful in urinary retention / obstruction
    1 Punarnava ̵ Boerhavia difusa Lin.
    2 Ushera ̵ Vetiveria zizanioides (Lin.) Nash.
    3 Sariva ̵ Hemidesmus indicus Schult.
    4 Chandana ̵ Santalum alba Lin.
    5 Gokshura ̵ Tibulus terestris Lin.
    6 Pashanabheda ̵ Bergenia ligulata (Wal.) Engl.
    7 Bala ̵ Sida cordifolia Lin.
    8 Shatavari ̵ Asp aragus racemosus Wild.
    9 Phalgu ̵ Ficus carica Lin.
    10 Ikshu ̵ Sugar cane ̵ Sacharum oficinarum Lin.
    1 Durva ̵ Cynodon dactylon (Lin.) Pers.
    12 Guduchi ̵ Tinospora cordifolia (Wild.) Miers.
    Ayurvedic formulations
    Formulations recomended in Urinary retention / obstruction:
    1. Gokshuradi gugulu
    2. Usherasava
    3. Punarnavadi gugulu
    4. Chandanasava
    5. Chandraprabha vati
    6. Trinapanchamola kashaya
    7. Chandrakala rasa
    8. Verataradi kashaya
    9. Godanti bhasma
    10. Vastyamayantaka ghrita
    1. Varunadi ghrita
    12. Trikantaka ghrita
    Wholesome diet in obstructed urine
    1. Sugar cane juice (ikshurasa)
    2. Milk (dugdha)
    3. Warm water (ushnodaka)
    4. Dry grapes ̵ raisins (draksha)
    5. Alkaline substances (kshara)
    6. Water melon (karkati)
    7. Musk melon (mamsa karkati)
    8. Cucumber (trapusa)
    9. Ash gourd (koshmanda)
    10. Fruit juice (phalarasa)
    1. Thin rice gruel (manda)
    12. Rest (vishrama) etc
    U nwholesome diet in obstructed urine
    1. Heavy exercise (vyayama)
    2. Spicy fod (vidahi ahara)
    3. Exhaustion (shrama)
    4. Dry fod (rukshahara)
    5. Junk fod (paryushiata ahara)
    6. Sexual indulgence (vyavaya)
    7. Awakening / reduced slep (jagarana)
    8. Supresion of natural urges (vegarodha)
    9. Biter gourd (karavelaka)
    10. Pulses ̵ dicotyledons (shimbi dhanya)
    1. Frozen beverages (ati shaityata)
    12. Incompatible fod stuf (virudhashana) etc
    Dear easy Ayurveda readers, I find pleasure in narating al the hiden facts related to the clasic but grave complaints like urinary retention. Even though the symptom may remain the same, the underlying patho-physiology is quite severe. This apears true in many diseases. So it is told in clasical Ayurveda literature that the enemies (enmity) and diseases should be checked as and when they originate and one should not wait til it completel y flares up.
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