Title: Successful Ayurvedic management of Chronic Kidney Disease stage 5 (ESRD) with Chronic cystitis due to severe   Stricture urethra with Severe Anemia-  A Case Report

Authors: Dr Sarita Pradip Gaikwad, Maj. Dr Pradip Yashwant Gaikwad

 DOI: https://dx.doi.org/10.18535/jmscr/v10i10.24

Abstract

Introduction: Stricture urethra in females is less common than that in males. The most common cause is idiopathic, iatrogenic i.e post instrumentation and post operative, inflammatory and traumatic. The complications are Hydroureteronephrosis, Cystitis, Repeated Urinary tract infection, and finally kidney failure.

Case Report: This 53 year old female experienced difficulty in passing urine. She was investigated and found to have extremely severe Stricture urethra due to stenosis of Ext urethral meatus, for which she was put on supra-pubic catheter with urobag. She developed Hydroureteronephrosis with chronic cystitis with severe Anemia. Her Serum Creatinine and Blood urea were high, making her land in to CKD stage 5 (ESRD) with eGFR 9 ml/min/1.73m2. Such a case was referred to Ayurved and was successfully treated by Abhyantar chikitsa, Panchkarma including Uttarbasti. One year of Ayurvedic treatment improved her CKD status to stage 4 (eGFR 17 ml/min/1.73m2). During Corona pandemic she could not be given course of Uttarbasti; later on she was given a course of 25 Uttarbasti in a span of 6 months, that made her stricture got cured. She could pass urine naturally. Her supra-pubic catheter with urobag was removed which she carried for nearly 30 months. She is totally symptom free and leading normal life with full quality of life.

Conclusion: Such a complicated case was successfully managed by Ayurvedic line of treatment. Ayurved has ability to treat incurable CKD-5 (End Stage Renal Disease), and severe Stricture urethra, which was confirmed again.

Keywords: Stricture urethra, Mutramarg Sankoch, CKD stage 5, ESRD, Ayurvedic management, Uttarbasti.

References

  1. Female Urethra Anatomy: Overview. https://emedicine.medscape.com/article/1972504-overview
  2. Urethral stricture. https://www.medindia.net/surgicalprocedures/urethral-stricture.htm
  3. K Rajgopal Shenoy and Anitha Shenoy (Nileshwar). Urinary bladder and Urethra. Chapter 40 in Manipal Manual of Surgery.4th Edition. CBS Publishers & Distributors Pvt.Ltd., New Delhi-110 092. 2014:962-967
  4. Sarin I, Narain TA, Panwar VK, Bhadoria AS, Goldman HB, Mittal A. Deciphering the enigma of female urethral strictures: a systematic review and meta-analysis of management modalities. Neurourol Urodyn. 2021;40(1):65–79. doi: 10.1002/nau.24584 [PubMed] [CrossRef] [Google Scholar][Ref list]
  5. Urethral stricture: Care at Mayo clinic. https://www.mayoclinic.org/diseases-conditions/urethral-stricture/care-at-mayo-clinic/mac-20362386
  6. Amiad Alwaal et al. Epidemiology of urethral stricture. Transl Androl Uro. 2014 Jun, 3(2): 209-213
  7. Das S. Shusruta of India, the pioneer in the treatment of urethral stricture. Surg Gynecol Obstet 1983; 157: 581– 2
  8. Sarita Gaikwad alias Sonale Sarita. Ayurvedic management of Chronic Renal Failure: A non randomized Ayurvedic Clinical trial. Indian Journal of Applied Research. Vol 7 (8) August 2017:88-94
  9. Anantram Sharma. Commentator. Sushruta Sanhita. Vol.3 Hindi medium. Chaukhamba Surbharati Prakashan, Varanasi-221 001.2015. Uttartantram Chapter 59 verse 19:483
  10. Bramhanand Tripathi Commentator Charak Sanhita Vol.2. Hindi medium. Chaukhamba Surbharati Prakashan, Varanasi-221 001. 2015. Chikitsa sthan Chapter 26 verse 45:872
  11. Bramhanand Tripathi Commentator Charak Sanhita Vol.2. Hindi medium. Chaukhamba Surbharati Prakashan, Varanasi-221 001. 2015. Siddhi sthan Chapter 9 verse 49-50:1284.
  12. Bramhanand Tripathi Commentator Charak Sanhita Vol.2. Hindi medium. Chaukhamba Surbharati Prakashan, Varanasi-221 001. 2015. Siddhi sthan Chapter 9 verse 67:1288.
  13. Rajendra H. Amilkanthwar. Role of Uttarbasti in Mutra marg sankoch (urethral stricture). Indian Journal of Traditional knowledge. Vol 3(2) April 2004:177-181.

Corresponding Author

Dr Sarita Pradip Gaikwad

M.D. (Manas rog), PhD (Kayachikitsa), Director, Punarnava Trimarma Chikitsalay and Research Centre, Nanded-431 602

Ex HoD Ayurved Research Department, Sassoon Hospital, Pune-411 001 and  Vol. Retd. Assistant Director, AYUSH, Pune region, Pune

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.