A presentation on Ayurvedic urinary disorders representing details and the treatment of diseases.

1. Urinary Disorders
Dr. Saurabh Sharma
B.A.M.S,D.N.H.E,N.D.D.Y,PGDHHM
Maharishi Ayurveda Hospital
Shalimar Bagh,
Delhi – 88

2. Kidneys
The kidneys are a pair of
brownish-red structures located
retroperitoneally (behind and
outside the peritoneal cavity) on
the posterior wall of the
abdomen from the 12th thoracic
vertebra to the 3rd lumbar
vertebra in the adult

3. Kidneys
• An adult kidney weighs 120 to
170 g (about 4.5 oz) and is 12
(about 4.5 inches) long, 6 cm
wide, and 2.5 cm thick.
•The kidneys are well protected
by the ribs, muscles, Gerota’s
fascia, perirenal fat, and the
renal capsule, which surround
each kidney.

6. Kidneys

7. Function of Kidneys
• Urine formation
• Excretion of waste products
• Regulation of electrolytes
• Regulation of acid–base balance
• Control of water balance
• Control of blood pressure
• Renal clearance
• Regulation of red blood cell production
• Synthesis of vitamin D to active form
• Secretion of prostaglandins

8. Ureters
Urine, which is formed within the
nephrons, flows into the ureter, a
long fibromuscular tube that
connects each kidney to the bladder.
The ureters are narrow, muscular
tubes, each 24 to 30 cm long, that
originate at the lower portion of the
renal pelvis and terminate in the
trigone of the bladder wall.
They convey urine from the kidneys
to the bladder

9. Bladder
The urinary bladder is a
muscular, hollow sac located just
behind the pubic bone.
The bladder is characterized
by its central, hollow area called
the vesicle, which has two inlets
(the ureters) and one outlet (the
urethrovesical junction), which
is surrounded by the bladder
neck.
capacity is about 300 to 600 mL
of urine

10. Urethra
The urethra arises from the base
of the bladder: In the male, it
passes through the penis; in the
female, it opens just anterior to
the vagina.
In the male, the prostate gland,
which lies just below the bladder
neck, surrounds the urethra
posteriorly and laterally.

11. Concept of Urine Formation In Ayurveda
• The concept of Urine formation in Ayurveda is different
to modern system of medicine.
• Ayurvedic texts say that Urine is formed in
Pakvashaya i.e, large intestine and it is separated by
the kidneys. So the composition and quantity of Ahara
(diet) influence the Mutra (urine) to significant extent
e.g, drinking of water in large quantities brings
corresponding increase in the excretions of urine or
taking certain heavily dried articles in the food may
make the colour of urine accordingly.

12. Diagrammatic representation of urine formation: -
According to different Samhita
AHARA
Paka Pachaka Pitta
Samana Vayu
Kledak Kapha
Atharveda Sushruta Sushruta Vagbhatta Sarangadhara
(1:3:6 ) (S.Sh.9/6) (S.Ni.3/21-23) (A.H.Ni.9/2) Puruvardga
6/10
Antra Adhogami Mutravaha Mutravaha Jaliyabhaga
Dhamani Nadi Sira of Maldrava
Gavini Mutravaha Sira
Dhamani
VASTI
MUTRA PRASEKA

13. Difference of 2 opinions of Urine formation:
Ayurveda Modern System of
Medicine
1. Source of Urine Diet taken by mouth Circulated blood.
2. Organ related to Pakvashya Intestines Kidneys
formation of
urine
3. Related part of Shaleshmickala Mucus Glomeruli
the organ memberanes
4. Other effecting Digestive juices, Blood Pressure cells of
objects Smanvayu tubules
5. Excretory Capillaries related to Uraters
channels intestines
6. Enteries in Micoscopic innumers Uraters

14. Common Disease of Urinary Tract
Ayurvedic Text it had been said: - Mutravahanam Srotsam
Bastirmulam Vankshnou Ch.Vim.5/F.
The sites of origin of the channels of excretion of Urine is
bladder and Vanksanouas (kidneys)
Pathological Condition:
 Excessive Urination (Atisrishtam)
 Complete suppression (Ativajram)
 Impairment in the composition of Urine (Prakupitam)
 Less in quantity (Alpam – Alpam)
 Heavy urine (Bhikshanam)
 Thick urine (Bahalam)
 Painful urine (Sashulam)

15. Mutra Vaha Strotas Vyadhi
Mutravaha Strotas Vyadhi
Mutrakriccha Mutraghata

16. Type Of Mutravahasrota Roga
Mutrakriccha (UTI) Mutraghaat
(Retention Of Urine)
Mutrasaad
Vataj
Mutrajadhar
Pitaj Mutrosukra
Kaphaj
Mutrasang
Sannipataj Mutracchay
Ashmarijanya
Mutrateet
Raktaj
Vata ashtila
Sukraj
Vata vasti
Purishaj
Ushna vat
Vat kundlika
Raktgrandh
i
Vid vighat
Vastikunda
l

17. Causes of Mutra Kriccha
• Excess intake of alcohol
• Intake of steroids
• Constipation
• Formation of stone
• Trauma
• Less fluid intake
• Retention of urine
• Depression
• STD

18. Signs and Symptoms of a Urinary Tract
Infection
•Frequent urge to pass urine.
•Scanty urine
•Feeling of fullness in the bladder even after
passing urine
•Pain and burning sensation while passing urine
•Feeling of pain in the pelvis, lower abdomen, and
in the urinary Tract.
•Feeling of heaviness in the renal region and
scrotum (Men).
•Blood in the urine. On examination of urine,
presence of pus cells and blood confirms UTI.
•Chills, fever

19. Men < Women
Urinary tract infections are much more common among women
than in men.
The reason is women have shorter Urethra – 3.5 cm long and
the urethra is closer to vagina and anus, where bacteria
thrive. The bacteria easily travels up the short urethra and
cause infections. Men’s urethra are longer – 20 cm long.
Hence urinary infections are less.

20. Urinary Disorders (Charak Sidhisthan 9/25-26)
13 types of Urinary disorders had been described:-
 Mutroksad – scanty urination, Oligurea.
 Mutrajathar – Distended bladder.
 Mutrakrichra – Dysurea.
 Mutrotsanga – Stricture of Urethra
 Mutrakshaya – Anurea
 Mutratit – Incontinence of Urine.
 Vatashthila – Enlarged Prostate .
 Vatbasti – retention of Urine.
 Ushanvat – Cystitis , burning micturition
 Vatkundlika – Spiral movement of Vayu or Spasmotic
stricture.
 Mutragranthy – Tumor of the bladder.
 Vidvighat – vesico-rectal fistula.
 Bastikundal – atony condition of bladder.

21. Signs and Symptoms of Mutraghaat
•Dribbling Micturition
•Mild pain over renal angle
•Fullness feeling over supra pubic region
•Pain and burning sensation while passing urine
•Bad taste of mouth
•Feverish feeling

22. 1. Mutroksad:
Difficulty in urination and the urine is scanty, yellowish,
whitish or reddish in color. This is due to aggravated Pitta
and Kapha.
Treatment:-
 Punarnavakshar 125mg to 250 mg with Arqu Makoya
 Gokshuradi Goggulu 2gm in 3 divided doses.
 Gokshuradi Qwath 20 to 30 ml with water TDS.

23. 2. Mutrajathar:
When apan Vat gets aggravated it starts moving upwards,
accumulated in the abdomen and causes distension of the
bladder, this causes severe pain and obstruction to the urinary
passage.
Treatment:-
 Uttrabasti of Varun Qwath
 Trinapanchmool quath 3tsp +5tsp water ( Muhur muhu)

24. 3. Mutrakrichra:
• Difficulty or painful micturition. This is due to UTI (Urinary
Tract Infection) Elaborately described in Ch.Ch.26/32
Treatment-
 Gokshru + Punarnava + Shatavari + ushira + Chandan
Powder mixture 2 to 4 gm with Trinpanchmool Qwath 30
ml x 2 if acute then after every one hour.

25. 4. Mutrotsang:-
There is obstruction to the flow of the urine due to stricture
in urethra. The urine comes out slowly in small quantity
and is tinged with blood. The flow of the urine can be with
or without pain.
Treatment:-
 Uttrabasti of Varun Qwath .
 Chandanadi Lauh 250mg + Shvet parpati 125mg BD with
honey.

26. 5. Mutrakshaya:- (Anurea)
The urinary output is reduced and due to Vat aggravation in a
person who indulges in extremely dry and cold foods and drinks
and carries excessive physical exercise. This is related to
Chronic Renal failure.
Treatment:-
Depends upon the cause General Treatment is:-
 Punarnava Kshar with Gokshur Kshar 500mg -1gm
Trinpanchmool Qwath 30 ml thrice a day.
 Sarivadyashav or Punarnava Rishta 20 ml x 2 dos with equal
quantity of water (after meals).
 Trinpanchmool Decoction for drinking.

27. 6. Mutratit:-
Incontinence of urine due to Vat aggravation the urge of
urination for long time suppresses, either fails to avoid the
urine with normal speed or incontinence of urine.
Treatment:-
 Shatavari churan and rasna churan with Trinpanchmool
Qwath 20 to 30 ml x thrice a day.

28. 7. Vatsthila:-
Prostate enlargement & aggravated Vat causes enlarge
size, hard gland between bladder and rectum this can
cause obstruction to the feces flatus and urine. The growth
of prostate is due to old age or due to malignant growth.
In the initial phase, the patient has to get up at night to
urinate frequently. He cannot empty his bladder
completely. Due to the enlargement of prostate gland
some urine always remains in the bladder. Afterwards,
there is obstruction to the flow of the urine and the
person has to strain at the time of urination.
I. Vata type: Along with urinary complaints, there is backache,
constipation, and weakness.
II. Pitta type: Due to inflammation of the prostate gland, there is
fever and urine is yellowish or reddish in color.
III. Kapha type: There may be associated symptoms like edema
on the feet due to water retention.

29. Treatment:-
I. Vata type: Anti-Vata diet should be advised. In the early
stage, herbs having scraping action particularly on urinary
system like gokshura, punarnava, guggulu, and shilajatu are
useful. Mixture of any three herbs in equal parts, in dose of 1
to 3 gm a day should be given for 1 month.
Fomentation in a tub bath is very beneficial. Cleansing enema
with dashamula decoction is indicated, which should be given
alternate with oil enema.
II. Pitta type: Cooling diuretics like coriander and punarnava
should be given in dose of 2 gm a day for 15 days.
III. Kapha type: Along with guggulu or shilajatu spices like
curcuma and chavya should be given.
IV. Gokshuradi Guggulu is the best drug 2 tab TDS with water

30. 8. Vatbasti:-
Vat gets aggravated in a person who suppresses the urge
of urination for long time causing retention of urine and
pain in the region of urinary bladder.
Treatment:-
 Gokshuradi Guggulu 500 mg x 2
 Chandraprabha Vati 500 mg x 2
 Trinpanchmool Qwath 20 ml with 50 ml of water

31. 9. Ushanvat:-
Over indulgence in physical exercise, long distance walking and
exposure to sun causes aggravation of Pitta. This when gets
associated with Vata in urinary tract, causes burning sensation
in the bladder, rectum and urethra. The urine comes out with
blood or and flows out in small quantity and there is frequency
of micturition also. This condition is usually found in cystitis or
urethritis.
Treatment:-
• Mukta pisthi and Gokshuradi guggulu B.D
• Guggulu with Ushir – chandani shrit Qwath 30 ml (Cold Qwath)
• Sandalwood oil 2 -3 drops with milk twice a day.
• Ksheerbala 101 with giloya faant.

32. 10. Vatkundlika:-
Aggravated Vat gets accumulated in the bladder and causes
severe pain and scant micturition. This can be compared with
spasmodic stricture.
Treatment:-
 Cold fomentation or Dhara at the bladder area. Or mud
gauge at the area for the instant relief.
 Shvet parpati and Giloya satav with punarnava kashayam

33. 11. Mutragranthy:-
In this, round solid mass gets developed inside the bladder and
the symptoms are similar to that of stone or tumor in the
bladder. The urinary output is reduced and is associated with
blood or pieces of flesh.
Treatment:-
 Punarnava ark + Sphatik bhasma +Godanti bhasma –all 125mg
each with lemon juice. BD

34. 12. Vidvighat:-
This is due to the formation of sinus tract between the
rectum and bladder. This is quite serious condition in which
the urine has fecal smell.
Treatment:-
 Surgical

35. 13. Bastikundal:-
Due to excessive exercise, injury to the bladder to lose it
tone, hence the patient passes urine with difficulty and pain.
Treatment:-
 Surgical

36. Causes of urinary system disorder
•Excessive consumption of alcoholic beverages
•Spicy and sour foods
•Excessive exposure to sunlight
•Dehydration
•Frequently controlling urination for extended
periods of time
•Too much of negative emotions like anger and
jealousy

38. Punarnava (Boerhavia-diffusa)

39. Shatavari

40. Gokshura (Tribulus Terestris)

41. Pashanbheda

42. Shilajeet

43. Varuna

44. Common Herbs for Urinary Disorders
•Gokshura fruit (Tribulus terrestris)
•Pashanabheda root (rockfoil / Bergenia ligulata)
•Pueraria tuber (vidari / Pueraria lobata)
•Punarnava plant/root (Boerhavia difusa)
•Shilajita Rasayana
•Shukti Bhasma (oyster shell ash /Ostrea gigas)
•Yavakshara alkaline ash (barley plant / Hordeum vulgare)
•Patol (Tricosanthe dioica)
•Makoya

45. Common Medicines for Urinary Disorders
• Trinpanchmool Quath
• Punarnava mandoor
• Chandraprabha Vati
• Ark makoya
• Varunadi Kashaya
• Pashanbheda churan
• Chandanadi Lauh
• Vangeshwar ras
• Shilajeet Vati
• Gokshuradi guggulu
• Varunadi kashaya
• Chandanasava
• Punarnavaristha

46. Emergency treatment
In case of urinary obstruction……
Give ….
Yavakshaar 125mg + Giloya satva 300mg –
thrice daily until patient urinates

47. Queries please….