🔺CASE STUDY NO : 43 🔺PART NO : 1 🔺MUTRAGHATA 🔺 NIDANAM (ETIOLOGICAL FACTORS) -Ativyayama – Excessive physical exertion -Ati Ruksha Anna Sevana – Excess intake of dry food -Vegadharana – Suppression of natural urges, especially Mutravegadharana -Abhighata – Trauma to the pelvic region -Basti Dushti – Dysfunction of the bladder due to various factors(Reference:Charaka Samhita Chikitsa Sthana 26/6-7 Sushruta Samhita Uttara Tantra 58/3 Ashtanga Hridaya Nidana Sthana 9/2) 🔺 PURVAROOPAM (PRODROMAL SYMPTOMS) -Manda Mutrapravritti – Sluggish urination -Basti Vedana – Pain in bladder region -Guda & Medhra Vedana – Pain in anal and penile region -Trishna, Daha – Thirst, burning sensation(Classical Reference: Ashtanga Hridaya Nidana Sthana 9/4) 🔺 LAKSHANAM (CLINICAL FEATURES) -Mutraghata is classified into 13 types, including: -Vataja Mutraghata – Retention of urine due to Vata -Mutrajatharaghata – Vata obstructing both bladder and intestines -Mutrashukraghata – Obstruction of both semen and urine -Mutravruddhi – Distended bladder due to urine accumulation -Ashmarighata – Obstruction due to urinary calculus -Vastibandha – Complete urinary obstruction due to severe Vata vitiation 📌Common Symptoms: -Mutranaha – Anuria or oliguria -Basti Shoola – Bladder pain -Guda, Medhra, Vankshana Shoola – Pain in surrounding areas -Udarashoola – Abdominal pain -(Classical Reference: Charaka Chikitsa 26 Ashtanga Hridaya Chikitsa Sthana 9 Sushruta Samhita Uttara Tantra 58) 🔺 SYSTEMIC EXAMINATION (MODERN ASPECT) -General Examination: -Pallor (if chronic retention causing renal compromise) -Dehydration (if there is associated vomiting or reduced intake) -Blood pressure: May be elevated in renal dysfunction -Abdominal Examination:Palpation: Distended, tender suprapubic region indicating full bladder -Percussion: Dullness over bladder region -Auscultation: Normal bowel sounds (unless ileus is present) -Perineal and Genital Examination: -Prostate enlargement (Digital Rectal Examination in males) -Urethral stricture signs -Meatal stenosis -Pelvic mass in females (e.g., fibroid, uterine enlargement) 🔺 LABORATORY INVESTIGATIONS -Routine Blood Tests: -CBC – To check for signs of infection or anemia -Renal Function Test (RFT): -Serum Creatinine -Blood Urea Nitrogen (BUN) -Electrolytes – Especially potassium and sodium levels -Urine Examination: -Urine Routine & Microscopy: -Presence of pus cells – suggestive of UTI -RBCs – possible stones or trauma -Casts/protein – in renal involvement -Urine Culture & Sensitivity – To identify urinary tract infections -Ultrasound Abdomen and Pelvis: -Bladder volume (pre- and post-void residual) -Prostate size (in males) -Hydronephrosis (if there is back-pressure due to obstruction) -Stones or masses -Other Imaging: -X-ray KUB (Kidney-Ureter-Bladder) – For radiopaque stones -CT Urogram – For detailed anatomy in complex cases -Uroflowmetry – For evaluating urine flow rate -Cystoscopy – Direct visualization of urethra and bladder 🛑 Expected Results of Investigations -Urinalysis : Pyuria, hematuria, bacteriuria, crystalluria -RFT : (Urea, Creatinine) Elevated if there is post-renal acute kidney injury due to obstruction -Ultrasound : Distended bladder, post-void residual volume, enlarged prostate, hydronephrosis Uroflowmetry : Reduced flow rate (<10 ml/sec in BPH or stricture) -Cystoscopy : Urethral stricture, BPH, bladder mass, stones 🛑https://chat.whatsapp.com/JtHGdxv7A5SA9bAe8ZNIS2