CLINICAL APPROACH TO URINARY TRACT DISORDERS

(Mutravaha Sroto Vikara)

 Questions at bed side….
• Do you have any difficulty passing urine?
• How often do you go?
• Do you have to get up at night? how often?
• How much urine do you pass at a time?
• Is there any pain or burning?
• Do you ever have trouble getting to the toilet in time?
• Do you ever leak any urine? Or wet yourself involuntarily? Do you sense
when bladder is full and when voiding occurs?
• WOMEN;
• Whether sudden coughing/sneezing/laughing makes loose urine?
• ELDERLY:
• Do you have trouble starting your stream?
• Do you have to stand close to the toilet to void?
• Is there a change in force or size of your stream?
• straining to void?
• Is there dribbling when you are through?
 URINARY TRACT DISORDERS
(MOOTRAVAHA SROTO VIKARA)
Mootravaha sroto vikara

Mutra Ati pravruttaja Mutra Alpa/Apravruttaja

vyadhi Vyadhi

Prameha etc • Mutrakrichra

involved
Directly

• Mutraghata
Indirectly
• Mutrashmari
involved
Basic Concepts:
O
R
G
A
N
OF
THE
URINARY
SYSTEM
 ORGANCE OF THE URINARY SYSTEM

❑ lÉÉÍpÉümÉ׸MüOûÏqÉÑwMüaÉÑSuÉQè.¤ÉhÉ vÉãTüxÉÉqÉç |
LMü²ÉUxiÉlÉÑiuÉYMüÉã qÉkrÉã oÉÎxiÉkqÉÑïZÉÈ ||
oÉÎxiÉoÉïÎxiÉÍvÉU¶ÉæuÉ mÉÉæÂwÉÇ uÉ×wÉhÉÉæ aÉÑSÈ |
LMüxÉqoÉÎlkÉlÉÉã ½ãiÉã aÉÑSÉÎxjÉÌuÉuÉUÉÍ´ÉiÉÉÈ ||
AsÉÉouÉÉ CuÉ ÂmÉãhÉ ÍvÉUÉxlÉÉrÉÑmÉËUaÉëWûÈ |
qÉÔ§ÉÉvÉrÉÉã qÉsÉÉkÉÉUÈ mÉëÉhÉÉrÉiÉlÉqÉѨÉqÉqÉç ||
( xÉÑ.ÌlÉ.3/18-20 )
• URINE/MOOTRA

❑ --- after the kidneys filter blood and return most of

the water and solutes to the blood stream, the
remaining water and solutes constitute urine..

❑ AÉWûÉUxrÉ UxÉÈ xÉÉUÈ xÉÉUWûÏlÉÉã qÉsÉSìuÉÈ |

ÍvÉUÉÍpÉxiÉeeÉsÉÇ lÉrÉiÉÇ oÉxiÉÉæ qÉÔ§ÉiuÉqÉÉmlÉÑrÉÉiÉç ||
( vÉÉ.mÉÔ.6/6 )
❑ ÌuÉhqÉÔ§ÉqÉÉWûÉUqÉsÉÈ ||
( xÉÑ.xÉÔ.46/528 )
 Mootrotpatti (Formation of Urine)

Ahara

P Pachaka pitta
A Samana vata
K Kledaka kapha
A Pureesha dhara kala

Kitta
Sara
Mala Drava

Mutravaha dhamani (Rt. And Lt. Renal Artery)

Vrukka (Ahara jala Vahisira Moola)

Mutravaha Nadi (Nephrons)

Gavini (Ureters)
Medhra
Basti (Bladder) Medhra Mani
❑ mÉYuÉÉvÉrÉaÉiÉÉxiÉ§É lÉ|QûrÉÉã qÉÔ§ÉuÉWûÉxiÉÑ rÉÉÈ |
iÉmÉïrÉÎliÉ xÉSÉ qÉÔ§ÉÇ xÉËUiÉ:xÉÉaÉUÇ iÉjÉÉ ||
xÉÔ¤qÉiuÉɳÉÉãmÉsÉprÉliÉã qÉÑZÉÉlrÉÉxÉÉÇ xÉWûxÉëvÉÈ |
lÉÉQûÏÍpÉÂmÉlÉÏiÉxrÉ qÉÔ§ÉxrÉÉqÉÉvÉrÉÉliÉUÉiÉç ||
eÉÉaÉëiÉÈ xuÉmÉiɶÉæuÉ xÉ ÌlÉÈxrÉlSãlÉ mÉÔrÉïiÉã |
AÉqÉÑZÉÉixÉÍsÉsÉã lrÉxiÉÈ mÉɵÉãïprÉÈ mÉÔrÉïiÉã lÉuÉÈ ||
bÉOûÉã rÉjÉÉ iÉjÉÉ ÌuÉkSÏ oÉÎxiÉqÉÔï§ÉãhÉ mÉÔrÉïiÉã |
(xÉÑ.ÌlÉ.3/21-23)
• Act of Micturition:

- Avedana (without pain)

- Nimittakala (expelled out in stipulated time (15ml/sec))
- Rujuvega (Straight forward stream)
- Sashabda (with mild sound) (Kashyapa samhita)

-
 WORDS TO REMEMBER…
• Dysuria- Pain on urination
• Urgency- Unusually intense and immediate
desire to void
• Frequency- Abnormally frequent voiding
• Polyuria- Increase in urinary volume/24hrs-
- roughly exceeding 3litr.
• Nocturia- Urinary frequency at night
• Hesitancy- a delay in starting urination
• Retention-impairment of voluntary control of bladder
• - cannot evacuate at will
• Incontinence -impairment of voluntary control of bladder
• - cannot control at will
• Haematuria- blood in the urine
 • Applied aspect:
Vitiated mootravaha srotas
- Atisrushta (Frequency / quantity)
❑AÌiÉxÉ×¹qÉÌiÉoÉ®Ç mÉëMÑüÌmÉiÉqÉsmÉÉsmÉqÉpÉϤhÉÇ uÉÉ oÉWûsÉÇ
xÉvÉÔsÉÇ qÉÔ§ÉrÉliÉÇ qÉÔ§ÉuÉWûlrÉxrÉ xÉëÉãiÉÉÇÍxÉ mÉëSÒ¹ÉlÉÏÌiÉ - Ati baddha (Obstructed/Retention)
ÌuɱÉiÉç | - Prakupita (Provoked)
( cÉ.ÌuÉ.5/8 )
- Alpalpam (Scanty)
- Abhikshnam (Dribbling)
- Bahalam (Thick / Abundant urine)
- Sashulam (Dysuria) (Cha.Vi.5/8)

- Any injury to Mootravaha srotas:

- Anadda basti (Distention of urinary bladder)

- Mutranirodhah (Retention)
❑iÉ§É ÌuÉ®xrÉÉlÉ®oÉÎxiÉiÉÉ qÉÔ§ÉÌlÉUÉãkÉÈ xiÉokÉqÉãRíûiÉÉ cÉ |
( xÉÑ.vÉÉ.9/12 ) - Stabdha medhra
(Stiffness of urethera) (Su.Sha.9/12)
 - Mutra vruddhi laxana:

- Krute Api Akruta samjnata (Feeling of incomplete emptying)

-- Basti nistoda (Pricking pain)

(A.H.Su.11/13)

- - Mutra kshaya laxana:

-Alpa mutrata
- Krichra mutrata
- (A.H.Su.11/22)
MORBID DOSHA MANIFESTS>>>>

Vata--- neurogenic Bladder

- Change in volume of urine voided
- painful

Pitta--- pH imbalance
- burning

Kapha--- Polyuria
- Proteinuria
- Obstruction Pathology
 MUTRAKRICHRA – DYSURIA
• qÉÔ§ÉM×ücNíÇû SÒ:ZÉålÉ qÉÔ§ÉmÉëuÉ×̨É:
• A condition of Painful Micturition
• Infectious conditions of urinary tract
• Sama mutra
 NIDANA (AETIOLOGY)
• -
AHARAJA
• Teekshanoushadhi (Strong medication)
• Ruksha madhya (Dry alcohol consumption)
• VIHARAJA
• Ati langhana (Excessive fasting)
• Mutravega dharana (Suppression of micturition)
• Ati Vahana yana (Excessive traveling)
• Mutritasya –Strisevana
• Achankramana, Ati asana (Sedentary life)
• Ayasa (Tiredness)
ANYA - Abhighata (Injury)
- Prapeedana (Compression)
TYPES
• Vataja
• Pittaja
• Kaphaja
• Sannipataja
• Shalyabhighataja
• Pureeshaja
• Shukraja
• Ashmarijanya
 Clinical features: Vataja
- Pain dominant
- Frequency/ scanty urination
- Pain in Inguinal, Hypogastric, Urethral,Testicular
region
- Nervus dysuria.
AsmÉqsmÉÇ xÉqÉÑÎimÉQèrÉ qÉÑwMüqÉãWûlÉoÉÎxiÉÍpÉÈ |
ÄTüsÉÌ°ËUuÉ ¢ÑücNíãûhÉ uÉÉiÉÉbÉÉiÉãlÉ qÉãWûÌiÉ || xÉÑ E 59/4
 Pittaja
- Yellowish / Red colored urine dominant
- Acidic urine
- - Burning sensation,
- Acute cystitis / urethritis
-Acute Prostatic Abscess
WûÉËUSìqÉÑwhÉÇ U£üÇ uÉÉ qÉÑwMüqÉãWûlÉoÉÎxiÉÍpÉÈ |
AÎalÉlÉÉ S½qÉÉlÉÉpÉæÈ ÌmɨÉbÉÉiÉãlÉ qÉãWûÌiÉ || xÉÑ E 59/5
 Kaphaja
- Swelling / Heaviness in
bladder/urethra/testicular region is dominant
-cloudy urine
- Sub acute cystitis
- Sec infection –BPH
- Chronic UTI
ÎxlÉaSÇ vÉÑYsÉqÉlÉÑwhÉÇ cÉ qÉÑwMüqÉãWûlÉoÉÎxiÉÍpÉÈ ||
xÉǽ¹UÉãqÉÉ aÉÑÂÍpÉÈ vsÉãvqÉÉbÉÉiÉãlÉ qÉãWûÌiÉ || xÉÑ E 59/6
Sannipataja: - Mixture of all above-
-krichratamamhi krichrum
Shalyabhighataja:
- int/ext trauma
- vataja mutrakrichra laxana
(Raktaja) - Haematuria, Painfull..
Pureeshaja - Suppression of Pureesha vega –
- Vatagati
- Distention abdomina/ dysuria
Ashmarija - Presence of Ashmari/ Dysuria
Shukraja - Seen in Adults
- Suppression of Shukravega/ Dysuria
 OBSTRUCTIVE PATHOLOGIC
CONDITIONS OF URINARY TRACT

• Mechanical Obstruction
• Neurogenic Obstruction
• Other causes
 NEURO-REGULATORY AXIS
PRANA-VYANA-APANA AXIS
• sarvepi mootraghataha prayasho vatajanya…
 MOOTRAGHATA

qÉÔ§ÉÉbÉÉiÉÉå qÉÔ§ÉÉuÉUÉåkÉ:,MåüÍcÉSÉbÉÉiÉzÉoSålÉ SÒ̹qÉÉWÒû: lÉ iuÉuÉUÉåkÉÇ,

qÉÔ§ÉzÉÑ¢üqÉÔ§ÉxÉÉSrÉÉåqÉÔï§ÉÉuÉUÉåkÉÉxÉÇpÉuÉÉiÉç
( xÉÑ E 59,1)
--vibandha bahulam , krichrutvamalpam…
 The word “MUTRAGHATA” is comprises of
two words viz. “Mutra” & “Aghata” means low
urinary output due to retention or relative anuria
or oliguria.
Definition:
Acharya Dalhana has defined Mutraghata as
under:
मुत्राघ।तेन मुत्रावारोध: (Dalhana Su. U.58/1)
Murtraghata is a clinical entity of Mutravaha
srotas, where there is obstruction of the urine
flow.
 Nidana (Eitiological Factors):-
1.Ativyayama - Excessive Exercises.
2. Teekshna Aushadha - strong potential drugs.
3. Rukshya madya prasanga - Excessive indulgence of
row alcohol.
4. Nityadrutya prusthayanat - Riding on the back of
fast moving Vehicles and animals.
5. Anupamastsya - Ingestion of flesh of wet landed
animals and fishes.
6. Adhyashana - Eating again before digestion of
previous food.
7. Ajeernat - Indigestion.
 SAMANYA NIDANA
• MOOTRA VEGA DHARANA
• 13 types- charaka
• 12 types- sushruta
 Types Su. Cha. Va. Dosa
Vatakundalika + + + Vata
Ashteela + + + Vata
Vata Basti + + + Vata
Mutrateeta + + + Vata
Mutrajathara + + + Vata
Mutrotsanga + + + Vata
+ + +
Mutrakshaya Vata-Pitta

Mutragranthi + + + Vata-Pitta
-Rakta
(Raktagranthi)
Mutrashukra ( + + + Vata-Pitta
Mutrakricchra)
Mutroukasada + + + Vata-Pitta
-Kapha
- + + Vata
Vidvighata
 Vatakundalika, Vata Basti and Mutrajathara can
be grouped under Neurogenic disturbances of bladder.
Ashteela, Mutragranthi, Mutrotsanga and
Bastikundalika can be grouped under Organic
disturbances, where the symptoms like- retention of
urine, increased frequency of micturition,
distension of abdomen, an mass felt per rectum
(which is developed due to a growth either in bladder,
urethra, prostate or other growths) are seen.
Mutrateeta, Mutrakshyaya, Ushna Vata,
Mutroukasada, Vidvighata and Mutrashukra can be
grouped under category of “Others”, where the
disturbance in urinary function is either due to
physiological reasons or injury etc.
 uÉÉiÉMÑühQûÍsÉMü
(Spasmodic stricture):

UÉæYzrÉɲåaÉÌuÉbÉÉiÉÉ²É uÉÉrÉÑuÉïxiÉÉæ xÉuÉåSlÉÈ|

qÉÔ§ÉqÉÉÌuÉzrÉ cÉUÌiÉ ÌuÉaÉÑhÉÈ MÑühQûsÉÏM×üiÉÈ||

qÉÔ§ÉqÉsmÉÉsmÉqÉjÉuÉÉ xÉÂeÉÇ xÉqmÉëëuÉiÉïiÉå|

uÉÉiÉMÑühQûûÍsÉMüÉÇ iÉÉÇ iÉÑ urÉÉÍkÉÇ ÌuɱÉixÉÑSÉÂhÉÉqÉç||

 ASTHEELA
( Prostate enlargement):

- Distention/ obstruction in bladder and anus

-Obstruction complete / partial
- Mobile mass
- Acute Pain

AÉkqÉÉmÉrÉluÉÎxiÉaÉÑSÇ ÂSèkuÉÉ uÉÉrÉѶsÉÉå³ÉiÉÉqÉç|

MÑürÉÉïxiÉÏuÉëÉÌiÉïqɹÏsÉÉÇ qÉÔ§ÉÌuÉhqÉÉaÉïUÉåÍkÉlÉÉqÉç||
 uÉÉiÉuÉÎxiÉ
(Retention of Urination):
uÉåaÉÇ ÌuÉkÉÉUrÉå±xiÉÑ qÉÔ§ÉxrÉÉMÑüzÉsÉÉå lÉUÈ|
ÌlÉÂhÉÉ̲ qÉÑZÉÇ iÉxrÉ uÉxiÉåuÉïÎxiÉaÉïiÉÉåÌlÉsÉÈ||
qÉÔ§ÉxÉ…¡û pÉuÉå¨ÉålÉ uÉÎxiÉMÑüͤÉÌlÉmÉÏÌQûiÉ:|
uÉÉiÉuÉÎxiÉ: xÉ ÌuÉ¥ÉårÉÉå urÉÉÍkÉÈ M×ücNíûmÉëxÉÉkÉlÉÈ||
 qÉÔ§ÉÉiÉÏiÉ
(Urge Incontinence of Urine):

ÍcÉUÇ kÉÉUrÉiÉÉå qÉÔ§ÉÇ iuÉUrÉÉ lÉ mÉëuÉiÉïiÉå|

qÉåWûqÉÉlÉxrÉ qÉlSÇ uÉÉ qÉÔ§ÉÉiÉÏiÉÈ xÉ EcrÉiÉå|| (cÉ ÍxÉ 9)
mÉëuÉÉWûiÉÉå qÉlSÂeÉqÉsmÉqÉsmÉÇ mÉÑlÉ: mÉÑlÉ ||
qÉÔ§ÉÉiÉÏiÉÇ iÉÑ iÉÇ ÌuɱÉlqÉÔ§ÉuÉåaÉ ÌuÉbÉÉiÉeÉqÉç || (xÉÑ E 59)
 qÉÔ§ÉeÉPûU
(Distended bladder):

qÉÔ§ÉxrÉ uÉåaÉå AÍpÉWûiÉå iÉSÒSÉuÉiÉïWåûiÉÑMüÈ|

AmÉÉlÉÈ MÑüÌmÉiÉÉå uÉÉrÉÑÂSUçÇ mÉÔUrÉåS pÉëÔzÉqÉç||
lÉpÉåUkÉxiÉÉSÉkqÉÉlÉÇ eÉlÉrÉåxiÉÏuÉëuÉåSlÉqÉç|
iÉlqÉÔ§ÉeÉPûUÇ ÌuɱÉSkÉÉåuÉÎxiÉÌlÉUÉåkÉlÉqÉç|| (Cha si)
 Mootra Sanga
(Stricture of urethra):

uÉxiÉÉæ uÉÉ AÌmÉ AjÉuÉÉ lÉÉsÉå qÉhÉÉæ uÉÉ rÉxrÉSåÌWûlÉÈ|

qÉÔ§ÉÇ mÉëuÉëѨÉÇ xÉ‹åiÉ xÉU£Çü uÉÉ mÉëuÉÉWûiÉÈ ||

xÉëuÉåiÉç zÉlÉæ: AsmÉqÉsmÉÇ xÉÂeÉÇ uÉÉ AjÉ lÉÏÂeÉÇ

 qÉԧɤÉrÉ
(Oliguria or Suppression of urine):

Vata-pittaja condition - No formation of urine

Urge present - Painful if pressurized
Acute nephritis - Acute dehydration etc.

äÉxrÉ YsÉÉliÉSåWûxrÉ uÉÎxiÉxjÉÉæ ÌmɨÉqÉÉÂiÉÉæ|

qÉԧɤÉrÉÇ xÉÂaSÉWÇû eÉlÉrÉåiÉÉÇ iÉSÉÀûrÉqÉç||
 qÉÔ§ÉaÉëÎljÉ
(Enlarged prostate or tumor of bladder)
- Enlarged mass Immobile mass
- Round mass - Small size mass
- Resembles calculi
- Differs due to Raktadhatu involvement
- surgical condition

AliÉuÉïÎxiÉqÉÑïZÉå uÉרÉÈ ÎxjÉUÉå AsmÉ: xÉWûxÉÉ pÉuÉåiÉç|

AzqÉUÏiÉÑsrÉ ÂaaÉëÎljÉqÉÔ§ÉaÉëÎljÉ: xÉ EcrÉiÉå||
 qÉÔ§ÉzÉÑ¢ü
(VESICAL SEMINAL DISCHARGE):
- Sexual indulgence with urine urge
- Urine mixed with semen
- Increased thickness of shukra causes dysuria
- Different from shukrameha with having dysuria
qÉÔ̧ÉiÉxrÉ Îx§ÉrÉÇ rÉÉiÉÉå uÉÉrÉÑlÉÉ zÉÑ¢üqÉѬèiÉqÉç|
xjÉÉlÉÉcrÉÑiÉÇ qÉÔ§ÉrÉiÉ: mÉëÉMçü mÉzrÉÉ²É mÉëuÉiÉïiÉå||
pÉxqÉÉåSMümÉëiÉÏMüÉzÉÇ qÉ賈 zÉÑ¢Çü iÉSÒcrÉiÉå|
VESICAL SEMINAL DISCHARGE
• Weakness of bladder sphincter
• Retrograde seminal ejaculation into bladder
• Cloudy urine
• Sperms in urine
 qÉÔ§ÉxÉÉS
(Scanty urination):

ÌmɨÉÇ MüTüÉå ²ÉuÉÌmÉ uÉÉ xÉWÇûlrÉåiÉå AÌlÉsÉålÉ cÉåiÉç|

M×üNíûÉlqÉÔ§ÉÇ iÉSÉ mÉÏiÉÇ µÉåiÉÇ U£Çü bÉlÉÇ xÉ×eÉåiÉç||

xÉSÉWÇû UÉåcÉlÉÉzÉlZÉcÉÔlÉï pÉuÉå¨ÉÑ iÉiÉç|

zÉÑwMÇüç xÉqÉxiÉuÉhÉïqÉç uÉÉ qÉÔ§ÉxÉÉSÇ uÉSÎliÉ iÉqÉç||

 EwhÉ uÉÉiÉÇ (Cystitis or Urethritis):
- Vata-Pittaja
- Burning sensation in bladder /urethra/anus
- Yellowish / Red urination/ haematuria/
- Frequency
- Cystitis, Gonorrhea
- pitta jwara chikitsa

urÉÉrÉÉqÉÉkuÉ AÉiÉÉmÉæ:ÌmɨÉÇ uÉÎxiÉÇ mÉëÉmrÉÉÌlÉsÉÉÎluÉiÉqÉç|

uÉÎxiÉÇ qÉåSìÇ aÉÑSÇ cÉæuÉ mÉëSWåû ixÉëÉuÉrÉåSkÉ:|
qÉÔ§ÉÇ WûËUSìqÉjÉuÉÉ xÉU£Çü U£üqÉåuÉ uÉÉ||
M×üNíûÉimÉÑlÉ: mÉÑlÉeÉïliÉÑ EwhÉ uÉÉiÉÇ oÉëÑuÉÎliÉ iÉqÉç|
 CYSTITIS..URETHRITIS..
• Strenuous exercise
• pH
• s/o infection
• urgency
• frequency
• Yellow or red urination
Vidvighata (Recto-vesical fistula):
- Upward movement of feacal matter into the bladder
- Obstruction due to vata
- Stool mixed urine
- Recto-vesical fistula
- surgical condition
 RECTO-VESCICAL FISTULA
• Abnormal connection between bladder and
rectum
• Secondary to crohns disease, diverticulitis..
• Frequent UTI
• Faecal matter through urine
 uÉÉÎxiÉMÑühQûûsÉ
(Atonic condition of bladder):
- overflow incontinence
- Bladder tone lost
- large dilated urinary bladder that does not empty
-Painful, burning, dribbling micturition
- Pressure to bladder area – Urination
SØiÉÉkuÉsÉlbÉlÉÉrÉÉxÉæUÍpÉbÉÉiÉÉiÉç mÉëmÉÏQûlÉÉiÉç|
xuÉxjÉÉlÉɲÉÎxiɲبÉ: xjÉÔsÉÎxiÉ ÌiÉ aÉpÉïuÉiÉç||
zÉÔsÉxmÉlSlÉSÉWûÉiÉÉåï ÌoÉlSÒÇ ÌoÉlSÒÇ xÉëuÉirÉÌmÉ|
mÉÏÌQûiÉxiÉÑ xÉ×eÉå²ÉUÇ xÉxiÉqpÉÉå²åziÉÉÌiÉïqÉÉlÉç|
uÉÎxiÉMÑüèhQûûsÉqÉÉWÒûxiÉÇ mÉuÉlÉmÉëoÉsÉÇ mÉëÉrÉÉå SÒÌlÉïuÉÉUqÉoÉÑ̬ÍpÉ||
Atonic condition of bladder
overflow incontinence

•LMN lesions- defect in sacral

plexus
•Flaccid detrusor muscle
•Insensitive to stretch
•Enormous distended bladder
•Overflow incontinence
•Pressure on bladder dome results
in urination
Retention/incontinence
•Sphincter Apparatus
1. Bladder neck
2. Internal sphincter
3. External sphincter

• Functional incontinence
• Incontinence secondary to medications
❖ SADHYASADHYATA (Prognosis):
- All mootraghata are difficult to cure– Involvement
of basti marma.
- Vata basti in worst condition is very difficult to cure.
- Mootra Granthi, Vata Kundalika, Basti kundalika–
Serious in nature.
- Mootra kshaya – Curable with difficulty.
 TO SUMMERISE…….
• Mutravaha vikaraa are explained in detail in
ayurveda to speciality level
• Mutrakrichra encompass UTI
• Mutraghata encompass obstructive pathology
• Mutravega dharana ,thus morbid vata is the
main cause in manifestation of most of the
urinary tract conditions
• Precise diagnosis helps for precise treatment
• MOOTRASHMARI
❖ NIDANA (Aetiology):
- Suppressed urine urge
MOOTRASHMARI (Urolithiasis): - Excessive milk indulgence
(A.Hr.Ni.9, Cha.Chi.26, Su.Ni.3) - Reduced intake of water
Definition:
- High calcium content
- Hard stoney material
- Inheritance
- Present between kidney to Urethra.
- Hormonal imbalance

❖ SAMPRAPTI (Pathology):
Kapha/ Shukra Burnt with Dried
Bladder Pitta Vata

Stone
❖ TYPES:
Dosha Composition
Vataja Calcium Oxalates
Pittaja Uric acid, carbonates
Kaphaja Calcium Phosphates
Shukraja

❖POORVAROOPA (Prodroma):
- Basti adhmana - Bladder distention
- Atiruja - Pain in and around bladder
- Mutra basta sagandha - Urine smells like goats urine
- Mootrakrichra - Dysuria
- Jwara - Fever
- Aruchi - Anorexia
 ROOPA (Clinical features):
Samanya laxana
❖Pain –Umbelical, Suprapbic,
Perineal raphe
❖Obstruction - Bifurcation stream
❖Haematuria
❖Stranguary
Kaphata: * Pricking sensation
❖Heaviness / Coldness
❖Bigger in size, Honey / white colour
❖Phosphate calculi
Shukraja: * Adult age
❖Suppression of sexual act
❖Dysurea, Pressure dissolves stone
Vishista laxana
Vataja * Acute pain
❖ Bites tooth – lips
❖Holds urethra frequently
❖Drop by drop urination
❖Grey colour stone
❖Horn on surface
❖Oxalate calculi
Pittaja: * Burning sensation
❖Marking nut shape stone
❖Black / red / yellow colour
❖Uric acid / urate calculi
❖ SADHYASADHYATA (Prognosis):
- Curable in children
- Difficult to cure / Incurable – Adult
Swelling in testis
Retention of urine
Unbearable pain
❖ CHIKITSA (Management):
- Abhyanga – Swedana - Snehapana
- Vasti - Uttaravasti
- Avagaha - Parisheka
- Dharasweda - Mootravirechana drugs
- Anuloma
- Pashanabheda, Shilajatu, Gokshura, Punarnava
- Surgical intervention if necessary
 TO SUMMERISE…….
• Mutravaha vikaraa are explained in detail in
ayurveda to speciality level
• Mutrakrichra encompass UTI
• Mutraghata encompass obstructive pathology
• Mutravega dharana ,thus morbid vata is the
main cause in manifestation of most of the
urinary tract conditions
• Precise diagnosis helps for precise treatment