One symptom may be found in many diseases. For the patient, that symptom gives discomfort. But for a physician each and every symptom is important to understand the patho-pysiology (origin of the disease) and to exactly diagnose the case.
Dysuria – difficulty in urination (mutrakricchara) and urinary obstruction (mutraghata) are two such disease entities, where ‘difficulty in urination’ is the common feature.
Many a times, many diseases may have same causative factors. But, based upon the nature of the individual, season of affliction, supporting food and habits, individual’s susceptibility and severity of the functional (often structural) entities, these two kinds of diseases are manifested.
kidney stones
Common causative factors of the disease urinary tract obstruction, its clinical features, disease classifications, probable line of treatment and common Ayurvedic remedies are discussed here below-
Obstructed urine (Mutraghata) is a dis-eased condition where ‘retention of urine’ is the cardinal feature, whereas in dysuria (mutrakricchara), difficulty in micturition is the typical characteristic feature. Obstruction and hence retention of urine may be caused by occlusion of the urinary tract or inflammation in the urinary pathway. Often injury, constriction/compressed stones or any other possible foreign bodies may result in this pathological condition.
Urinary obstruction causes:
1. Vegadharana (suppression of natural urges)- Read a related article
2. Rooksha ahara (intake of dry food and less intake of water) – Rooksha means dry, Ahara means food.
3. Sroto rodha (obstruction to the urinary tract due to stones, gravel, foreign body etc). Sroto means body channel, rodha means obstruction.
Origin of Retention of urine:
Due to the above said causative factors the Doshas get aggravated. It is predominantly Vata Dosha. The vitiated Doshas mix up with (samsarga) urine and hence obstruct the flow of urine. Here, due to the influence over Apana vata, cited at Basti pradesha (bladder) the pathology continues and the urinary retention is caused.
Common clinical features of urinary obstruction:
Here, one can find several possibilities like interrupted flow of urine, complete obstruction of the urinary tract, non production of urine, reduced or incomplete production of urine, incomplete or complete excretion of urine etc.
Classification of urine obstruction:
Based upon the clinical features, Ayurvedic text books explain 3 kinds of urinary obstruction.
1. Vata kundalika:
Due to dry food, less intake of water or suppression of natural urges, Vata dosha is vitiated and it is lodged in bladder. As it vitiates urine, it is retrograded (kundalikrita) and drive the urine in interrupted manner.
It is common in the people who work in night shift and in those who take junk and spicy food excessively.
2. Ashteela (Vatashteela):
Specific causes aggravate Vata dosha and hence obstruct the urinary pathway by distending the bladder and rectum. This causes severe pain during urination as well as defecation.
This is common in the people who are with sedentary life style.
3. Vata basti:
Constant suppression of urinary urge (due to various personal factors), aggravated Vata obstructs the urethral orifice of the urinary bladder. Thus, it inhibits the excretion mechanism of urine. This leads to partial or full retention of urine in the bladder. Ultimately it causes pain in the abdomen and supra pubic (lower abdomen) area. Often itching or irritation may be also associated as there is relaxation of muscular coat and contraction of sphincters.
It is very common in working women, executives and people who travel for long.
4. Mutrateela:
Withholding (suppression) the urinary urge for longer duration or post pone of the urge results in gradual (slow) excretion of urine when one goes for urination. This is called mutrateela. In this condition often pain may complain passing little by little urine. This is usually caused due to fatigue of the muscles and sphincters due to constant withholding of urine.
This is common in women, drivers, executive officers, managers and those with high profession who are busy due to their work schedule.
5. Mutra jatara:
Constant suppression of urinary urge leads to back pressure and hence the bladder is distended. Further, vitiated Apana vata occupies whole bladder and nearby organs and causes severe distention due to exerted pressure. Thus, it creates excruciating pain in the lower part of the bladder. Often gaseous distention of abdomen and constipation are also associated. When the individual goes for urination, large amount of urine is passed with difficulty in prolonged time period. It is common in the school children, security guards and officers, accountants, bank employees, painters etc.
6. Mutrotsanga:
When the urine is obstructed in the bladder or urethra for longer duration, due to various factors (functional or structural), there will be haematuria (blood with urine). Or else little urine is passed with difficulty (dribbling) or with pain. Such a condition is called as Mutrotsanga. Obstruction due to foreign bodies or urinary stones may also lead into such a condition.
This is commonly witnessed in the patients with long persisting diseases of urogenital system like urinary calculi, recto-vesicle fistula, chronic kidney disorders etc.
7. Mutrakshaya: In the individuals who are physically exhausted, those who suffer from dehydration (primary or secondary), the aggravated vata and pitta Doshas occupy the bladder. Due to this, the quantity of output of urine is reduced and hence pain and burning sensation are associated with the main complaint of dysuria. This condition is called Mutrakshaya in Ayurvedic classics. Kshaya means decrease. Mutra means urine.
This is common in the laborers who work near the fire and in chemical factories, mines etc.
8. Mutragranthi:
Due to the respective factors rakta (blood), vata and kapha are vitiated and they are lodged in the urethral orifice causing a cystic or nodular growth. Due to this, the person passes the urine with much difficulty. The patient will feel excruciating pain similar to the pain caused during urinary calculi. The condition is known as Mutra granthi.
This is seen commonly witnessed in bed ridden patients.
9. Mutrashukra: Shukra means semen. The person who indulges in sex, while he is having the urge of urination, will ejaculate the semen mixed with urine or excretes the urine before or after seminal ejaculation. In this condition, the semen appears like ash dissolved in urine.
This diseases condition is found only in men and in those who have severe sexual urge and unplanned sexual indulgence.
10. Ushna vata: Heavy exercise, long walk under extreme Sunligh cause the aggravation of pitta and vata dosha. The aggravated doshas are lodged in the urinary pathway. There, it causes inflammation in the nearby areas -bladder, urethra, rectum etc. This leads to yellowish urine or blood mixed urine. In this condition, the individual passes the urine with difficulty (dysuria) and very frequently. Severe pain is also associated. It is observed in the outdoor workers, laborers, sports persons etc.
11. Mutrasada:
Vitiated pitta and kapha doshas together lodged in urinary bladder. There, the urine is concentrated and consolidated by Vata dosha. It produces reddish yellow (hematuria) urine which is often associated with solids (cast cells). Burning sensation, dysuria and itching are also associated in this condition.
It is common in the patients with chronic renal failure or dehydration conditions.
12. Vidwighata: Vit means faeces Vighata means obstruction.
In the individuals with dry nature (vata prakriti) and who are debilitated, often vata aggravates and the stools are derived upwards (retrograded). Meanwhile, vitiated Vata moves through the urinary tract and enters the bladder. Due to this, the individual excretes urine with the smell of stools. Difficulty in micturition is associated along with mild pain.
It is found as surgical complication in few of the surgeries related to the abdominal organs or uro- genital system.
13. Basti kundala:
Long travelling or heavy brisk walk, jumping, falling, physical exertions, injury etc may cause the disposition/prolapse of the urinary bladder. Due to this, the bladder will bulge and attain upward protrusion. This causes severe pain, pulsation, burning sensation and distress. This ultimately leads to interrupted urine, pain and stiffness, cramps, distress in the lower abdomen (supra pubic area), heaviness etc.
This is common in accidental injuries, sports injuries, wrestling, stampede etc.
General line of treatment of Obstructed urine:
The general line of treatment of urinary obstruction includes oleation (snehana), sweating therapy (swedana), oleaginous purgation (snigdha virechana), enema (basti) and urethral enema (uttara basti). Among the oral medications, priority is given for soothening, coolant, sweet and unctuous- diuretic (mutrala) substances.
Single drugs useful in urinary retention/obstruction:
1 Punarnava – Boerhavia diffusa Linn.
2 Usheera – Vetiveria zizanioides (Linn.) Nash.
3 Sariva – Hemidesmus indicus Schult.
4 Chandana – Santalum alba Linn.
5 Gokshura – Tibulus terrestris Linn.
6 Pashanabheda – Bergenia ligulata (Wall.) Engl.
7 Bala – Sida cordifolia Linn.
8 Shatavari – Asparagus racemosus Willd.
9 Phalgu – Ficus carica Linn.
10 Ikshu – Sugar cane – Saccharum officinarum Linn.
11 Durva – Cynodon dactylon (Linn.) Pers.
12 Guduchi – Tinospora cordifolia (Willd.) Miers.
Formulations recommended in Urinary retention/obstruction:
1. Gokshuradi guggulu
2. Usheerasava
3. Punarnavadi guggulu
4. Chandanasava
5. Chandraprabha vati
6. Trinapanchamoola kashaya
7. Chandrakala rasa
8. Veerataradi kashaya
9. Godanti bhasma
10. Vastyamayantaka ghrita
11. 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 groud(kooshmanda)
10. Fruit juice (phalarasa)
11. Thin rice gruel (manda)
12. Rest(vishrama) etc
Unwholsesome diet in obstructed urine:
1. Heavy exercise (vyayama)
2. Spicy food (vidahi ahara)
3. Exhaustion (shrama)
4. Dry food (rukshahara)
5. Junk food (paryushiata ahara)
6. Sexual indulgence (vyavaya)
7. Awakening (reduced sleep)(jagarana)
8. Suppression of natural urges(vegarodha)
9. Bitter gourd(karavellaka)
10. Pulses (dicotyledons) (shimbi dhanya)
11. Frozen beverages (ati shaityata)
12. Incompatible food stuff (viruddhashana)etc
Dear easy Ayurveda readers, I am finding pleasures in narrating all the hidden facts related to the simple but grave complaints like urinary retention. Even though the symptom may remain the same, the underlying patho-physiology is quite severe. This appears true in many diseases. So it is told in classical Ayurveda literature that the enemies (enmity) and diseases should be checked as and when they are originated and one should not wait till it completely triggers up.
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