Effect of Haridradi Yoga, Narikel Kusum Yoga, and Yavakshara in the Management of Mutrashmari (~left ureteric calculus) : A Case Report

Abstract

Nephrolithiasis, known as Vrikkashmari in Ayurveda under the Mutravaha Srotas disorder, affects approximately 12% of the global population and 12% of the population in India. Acharya Sushruta classified Ashtamahagada (conditions that are challenging to manage) as stemming from the vitiation of Vata, Pitta, and Kapha doshas, leading to calculus formation within the urinary tract. While contemporary modalities include diuretics, lithotripsy, and surgical interventions, conservative Ayurvedic interventions are recommended in the early stages.  A 44-year-old male presented to the outpatient department (OPD) with left flank pain radiating to the suprapubic region, accompanied by dysuria. Non-contrast computed tomography (NCCT) of the kidneys, ureters, and bladder (KUB) confirmed a ~7 mm left mid-ureteric calculus causing mild upstream hydroureteronephrosis. Systemic examination and baseline vital signs were normal. The patient was treated with oral administration of Haridradi yoga 24 g twice daily with kanji [~fermented rice gruel water] alongside Narikel Kusum Yoga 48 g combined with Yavakshara (500 mg) once daily, supplemented by dietary and lifestyle modifications. Patient reported complete resolution of dysuria and significant pain reduction. Treatment was continued, and a follow-up ultrasonography (USG) performed at 22 days revealed complete clearance of the mid-ureteric calculus and resolution of hydroureteronephrosis. This case highlights the efficacy of classical Ayurvedic formulations (Haridradi yoga, Narikel Kusum Yoga, and Yavakshara) in achieving non-surgical calculus clearance and symptomatic relief in mid-ureteric nephrolithiasis.