Urinary System Disorders

Dr Swami Karmananda Saraswati, MB, BS (Syd.)

Disorders of urination are troublesome and common. Symptoms of urinary frequency, urinary incontinence, excessive urination, urethral discharge and pain on urination plague many men and women, and often prove difficult to eradicate. Often people suffer from recurrent bouts of urinary tract infections over many years and are prescribed innumerable courses of antibiotics, without ever gaining more than temporary relief, because the underlying root problem is not corrected.

The underlying cause of recurrent urinary tract infections is a deficiency of vital energy. This energy or prana shakti becomes depleted over many years, until the urinary and reproductive systems no longer possess the capacity to resist infection with micro-organisms, which are part of the normal bacterial flora of every human body. When the urinary excretion mechanisms become sluggish, stasis of urine occurs, and retrograde or ascending infections from the urethral orifice below are able to take hold.

The result is a range of symptoms including pain and burning on passing urine, frequent passage of urine, poor control and co-ordination of urination, urinary discharge, and so on. These symptoms are classified as different disease entities by medical scientists, depending on the exact site in the urinary system where the infection lodges and multiplies. Infection of the urethral passage which empties urine from the bladder to the outside is termed urethris, infection of the bladder is termed cystitis, and infection of the kidneys, ascending from the lower urinary tract is termed pyelonephritis. The important thing to remember is that each is really a different name for the same underlying process - a deficiency of energy in the urinary system resulting in bacterial overgrowth.

Infections of the reproductive system, which is closely related automatically and physiologically to the urinary tract, also produce symptoms of burning and pain on urination, urinary frequency, together with a urethral discharge, and signs of inflammation in the prostate gland. These are notoriously difficult to eradicate by conventional methods, but quickly correct themselves under yogic management. Orchitis and epididymitis- infections of the testes and seminal conducting pathways, are also common. These frequently develop in a system which is weakened by long term depletion of sexual and reproductive power through excessive and neurotic expression of the sexual instincts and desires.

In the female body, ascending infection frequently develops in the reproductive organs, which are very vulnerable and exposed to the outside environment. Vulvitis (infection of outer genital region), vaginitis, cervicitis (of cervix), endometritis (of uteric lining) and salpingitis (of the fallopian tubes) are often severe and long standing, and can easily result in sterility. Sexual activity is a common means of transmission of urinary and reproductive tract infections. It serves as a means of transfer of micro-organisms from one individual to another, as a visible manifestation of energy transfer and interaction occurring in the sexual act. Excessive, neurotically-inspired sexual activity, based on mental and emotional tension, boredom and frustration in life, depletes energy from the lower centres and makes them susceptible to infection, both via sexual transfer, and also from the neighbouring bowel and urethra. The venereal diseases such as gonorrhoea, non-specific urethritis, syphilis, infectious mononucleosis etc. are manifestations of this process, but cannot be really classed separately from the other urinary and reproductive infections, which may or may not enter through sexual interaction as well. The fundamental problem is one of energy depletion of the lower centres where vital economy has been depleted through excessive sensual gratification. In this way the sexual impulse becomes a source of pain rather than of pleasure, as it is intended to be, and abstention while vital re-accumulation reoccurs is a fundamental step in yogic management.

The urinary and genital tract

The urinary and reproductive systems are interconnected, and cannot really be considered in isolation, especially in the male, where they share a common urethral passageway for discharge through the penis. The urinary tract begins with the kidneys, two fist sized organs lying on the back wall of the abdominal cavity in the loin region. Each kidney is composed of millions of tiny filtering structures, nephrons which filter the bloodstream, removing excessive salt and water and extracting wastes of cell and protein metabolism such as urea, ammonia, uric acid, oxalic acid and so on, which together go to comprise the urine.

The urine passes into numerous collecting ducts within the kidney substance, which collect together to form the ureter. From each kidney a single ureter passes down into the pelvis and enters the bladder. The bladder is an expansive muscular bag in which urine is stored. It is continually filling from above as urine enters via the two ureters, and has the capacity to expand automatically as the volume of collected urine increases. When the bladder volume reaches a certain size, the brain receives a sensory nervous impulse to this effect and we become aware that we need to empty our bladder.

Emptying of the bladder is under voluntary nervous control (except in extreme cases of bladder overload due to withholding of the reflex to urinate). The urine is released into the urethra, the final conducting pathway which emerges from the base of the bladder. The differences between male and female systems commence at this point. In the male, the base of the bladder is encircled by the prostate gland- Entering this gland are the two vas deferens, one from each testis, which conduct the semen to the urethra. Beyond the prostate the urethra, a common passage for both urine and semen, passes to the outside. In the female body, the urethra passes directly to the outside distinct and separate from the vagina.

The base of the bladder rests upon the perineal (pelvic) floor, and obviously the female urethra is very short (approximately two inches), compared to the male, which leads through the penis. This is one major reason why simple urinary tract infection is far more common in women than men. The distance which a contaminating micro-organism must travel to reach the bladder is far shorter and thus infection is more likely to occur.

Urinary stasis or pooling of urine in the bladder, contributes to this, for the longer the short female urethra is left without the downwards flushing of fresh, antiseptic urine, the more likely is a bladder infection to gain hold, especially in a woman whose vital energy is lowered. That is why women who have proved susceptible to bladder infection are advised to drink plenty of water, and also to pass urine soon after completing the sexual act, when foreign micro-organisms are most likely to be introduced to the urethra. During pregnancy, urinary stasis and infection are especially frequent, as the bladder is compressed by the expanding uterus.

In males, urinary stasis is a common problem in later life. This occurs as the prostate gland hypertrophies (increases in size) - an effect of excessive male hormonal influence. The gland grows and encroaches inwards upon the urethra which passes through its lobes, so that the flow of urine is gradually and progressively obstructed. The process of prostatic hypertrophy is usually recognised and diagnosed in late middle or old age, but it is actually the end result of a process which begins in the early twenties. Unless the male sexual metabolism is balanced and controlled during early sexual life, the pathway of testosterone production becomes wayward and excessive in later life, and partial loss of urinary continence frequently occurs. As the gland encroaches on the urethral outlet, the urge to pass urine can only be satisfied by active straining, with the result that a small amount of urine dribbles through the urethra. No sooner is this accomplished than the urge occurs again, so that the passage of urine becomes a continual and time consuming preoccupation. Behind the glands a constant pool of urine lies stagnating, which can become infected, producing further irritation and difficulty in the urination process.

Medical management of urinary tract infections is based on antibiotic therapy, but little is known about the correction of underlying pranic energy deficiency which is the root cause. Prostatic hypertrophy is usually corrected surgically. The procedure known as trans-urethral resection, is performed very commonly today. The passage through the gland is widened so that urine and semen can flow freely.

Yogic management

Yogic management of urinary tract infection is aimed at restoring the depleted energy in the urinary and reproductive systems. When this underlying condition is removed, infections can gain no foothold in the urinary passages.

Surya namaskara is the most important pranic regenerator. It should be performed at sunrise, to capacity, building up to 12 or more rounds.

Asanas: Paschimottanasana, halasana, pashinee mudra, vajrasana, shashankasana, marjariasana, bhujangasana, trikonasana, ardha matsyendrasana.

Pranayama: Bhastrika pranayama to capacity is recommended to restore energy in combination with inner retention, moola bandha and jalandhara bandha. Nadi shodhana up to stage 4, should be performed over a 6 month period.

Shatkriyas: Neti and kunjal should be practised daily and laghoo shankhaprakshalana 3 times a week.

Mudras and bandhas: Moola bandha and vajroli mudra should both be practised daily 25 times, both in cases of urinary tract infections and prostatic hypertrophy.

Diet: A light diet, free of meat, excessive spices and oils, is highly recommended. This conserves digestive energy, enabling it to be redirected for healing purposes. Overeating should be avoided, and the evening meal should be taken around sunset. Tea and coffee in excess are harmful, and alcohol and tobacco should be discontinued. Fasting one day per week, or skipping the evening meal every few days also provides a great deal of energy required to throw off tenacious infections. Plenty of water is recommended, and amaroli can be commenced if desired.

Rest: Adequate rest is a necessity. A lifestyle based on social activity and late nights should be suspended at least for some months. If possible, staying in an ashram during this period is highly recommended. Relaxation and yoga nidra should be practised each afternoon.