KidneysThe kidneys are a pair ofbrownish-red structures locatedretroperitoneally (behind andoutside the peritoneal cavity) onthe posterior wall of theabdomen from the 12th thoracicvertebra to the 3rd lumbarvertebra in the adult
Kidneys• An adult kidney weighs 120 to170 g (about 4.5 oz) and is 12(about 4.5 inches) long, 6 cmwide, and 2.5 cm thick.•The kidneys are well protectedby the ribs, muscles, Gerota’sfascia, perirenal fat, and therenal capsule, which surroundeach kidney.
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
UretersUrine, which is formed within thenephrons, flows into the ureter, along fibromuscular tube thatconnects each kidney to the bladder.The ureters are narrow, musculartubes, each 24 to 30 cm long, thatoriginate at the lower portion of therenal pelvis and terminate in thetrigone of the bladder wall.They convey urine from the kidneysto the bladder
BladderThe urinary bladder is amuscular, hollow sac located justbehind the pubic bone.The bladder is characterizedby its central, hollow area calledthe vesicle, which has two inlets(the ureters) and one outlet (theurethrovesical junction), whichis surrounded by the bladderneck.capacity is about 300 to 600 mLof urine
UrethraThe urethra arises from the baseof the bladder: In the male, itpasses through the penis; in thefemale, it opens just anterior tothe vagina.In the male, the prostate gland,which lies just below the bladderneck, surrounds the urethraposteriorly and laterally.
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.
Diagrammatic representation of urine formation: - According to different Samhita AHARA Paka Pachaka Pitta Samana Vayu Kledak KaphaAtharveda 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
Difference of 2 opinions of Urine formation: Ayurveda Modern System of Medicine1. Source of Urine Diet taken by mouth Circulated blood.2. Organ related to Pakvashya Intestines Kidneys formation of urine3. Related part of Shaleshmickala Mucus Glomeruli the organ memberanes4. Other effecting Digestive juices, Blood Pressure cells of objects Smanvayu tubules5. Excretory Capillaries related to Uraters channels intestines6. Enteries in Micoscopic innumers Uraters
Common Disease of Urinary TractAyurvedic Text it had been said: - Mutravahanam SrotsamBastirmulam Vankshnou Ch.Vim.5/F.The sites of origin of the channels of excretion of Urine isbladder 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)
Type Of Mutravahasrota RogaMutrakriccha (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
Causes of Mutra Kriccha• Excess intake of alcohol• Intake of steroids• Constipation• Formation of stone• Trauma• Less fluid intake• Retention of urine• Depression• STD
Signs and Symptoms of a Urinary TractInfection•Frequent urge to pass urine.•Scanty urine•Feeling of fullness in the bladder even afterpassing urine•Pain and burning sensation while passing urine•Feeling of pain in the pelvis, lower abdomen, andin the urinary Tract.•Feeling of heaviness in the renal region andscrotum (Men).•Blood in the urine. On examination of urine,presence of pus cells and blood confirms UTI.•Chills, fever
Men < WomenUrinary 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.
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.
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
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.
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)
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.
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.
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.
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.
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.
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
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
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.
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
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
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
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
Causes of urinary system disorder•Excessive consumption of alcoholic beverages•Spicy and sour foods•Excessive exposure to sunlight•Dehydration•Frequently controlling urination for extendedperiods of time•Too much of negative emotions like anger andjealousy