Mutraghata is an Ayurvedic disorder of Mutravaha Srotas (urinary channels), characterised by impaired or obstructed urine flow. Its clinical presentations include difficulty in micturition, reduced urinary stream and retention. Some manifestations, particularly those associated with bladder outlet obstruction, have clinical similarities to lower urinary tract disorders such as benign prostatic hyperplasia (BPH). Shigru (Moringa oleifera), Gokshura (Tribulus terrestris) and Yavakshara are considered in traditional Ayurvedic approaches to urinary disorders.
Traditional rationale and proposed role
Ayurvedic management of Mutraghata considers the involvement of aggravated Vata and obstruction within the urinary channels. The selected ingredients have different traditional applications:
- Shigru (Moringa oleifera): Traditionally used in several Ayurvedic formulations, Shigru has also been investigated for urinary conditions. Its clinical evaluation in urinary tract infection and urinary calculi should be distinguished from evidence for urinary retention.
- Gokshura (Tribulus terrestris): Traditionally associated with urinary health, Gokshura is included in formulations used for Mutraghata and related urinary symptoms.
- Yavakshara: An alkaline preparation obtained from barley, traditionally used in selected Ayurvedic formulations for urinary disorders. Its proposed role should be understood within the classical application of Kshara preparations rather than as an established treatment for bladder outlet obstruction.
Clinical considerations and relevant applications
- Prostatic obstruction: Ayurvedic clinical investigations have evaluated Gokshura-containing formulations in men with BPH and symptoms associated with Mutraghata.¹,²
- Urinary symptoms: Changes in urinary frequency, stream, hesitancy and residual urine have been assessed in studies of combined Ayurvedic formulations.
- Clinical assessment: Urinary retention requires evaluation of its underlying cause, including prostatic enlargement, urethral obstruction, neurological dysfunction and medication-related effects. Acute inability to pass urine requires urgent medical management.
Evidence and research priorities
Clinical publications have primarily examined multi-ingredient formulations rather than Shigru, Gokshura or Yavakshara individually. Consequently, observed outcomes cannot be attributed to a single ingredient. Studies specifically evaluating Yavakshara and standardised preparations in urinary retention remain limited.
Conclusion
Shigru, Gokshura and Yavakshara have traditional relevance in Ayurvedic urinary care. Clinical investigations of Gokshura-containing formulations provide preliminary observations in BPH-associated urinary symptoms, but do not establish the individual efficacy of these three ingredients in urinary retention. Their role requires consideration alongside accurate diagnosis and appropriate urological management.
References
- Vasava YR, Bhuyan C, Rajagopala M, Gupta SK, Dudhamal TS. Effect of Mahayavanala Roma Kshara and Dhanyaka Gokshura Ghrita in benign prostatic hyperplasia. Ayu. 2010;31(3):332-337. doi:10.4103/0974-8520.77168. https://pmc.ncbi.nlm.nih.gov/articles/PMC3221067/
- Banothe GD, Mahanta V, Gupta SK, Dudhamal TS. A clinical evaluation of Kanchanara Guggulu and Bala Taila Matra Basti in the management of Mutraghata with special reference to benign prostatic hyperplasia. Ayu. 2018;39(2):65-71. doi:10.4103/ayu.AYU_117_15. https://pmc.ncbi.nlm.nih.gov/articles/PMC6369605/