Conservative Ayurvedic Management of a Mid-ureteric Calculus with Grade-2 Hydronephrosis: A Case Report

Abstract

Ureterolithiasis is a common urological disorder characterised by the formation of calculi within the ureters. Despite significant advancements in surgical and endourological interventions, high recurrence rates, postoperative discomfort, and the potential for complications highlight the need for safe, effective, and non-invasive treatment approaches. In Ayurveda, Ashmari (urinary calculi) is classified among the Ashtamahagada (eight extremely challenging diseases) and is managed through a holistic combination of herbal medications, dietary regulation, and lifestyle modification that aim to achieve Ashmari-bhedana (lithotriptic), Mutrala (diuretic), and Shoolahara (analgesic) effects. In this case report, a 28-year-old male diagnosed with a mid-ureteric calculus measuring 7.2 mm, a size generally considered suitable for surgical intervention, was successfully managed with conservative Ayurvedic treatment. The patient has a history of recurrent calculus formation and a past surgical history for calculus removal. An Ayurvedic therapeutic regimen comprising Gokshuradi Guggulu, Sweta Parpati, Sukumara Ghrita, Varunadi Kashaya, and Kumaryasava was administered for 10 weeks, accompanied by strict dietary and lifestyle guidance focusing on adequate hydration, avoidance of lithogenic foods, and adherence to light, easily digestible meals. The patient experienced complete symptomatic relief, with no painful episodes, urinary obstruction, or adverse effects. Follow-up ultrasonography revealed complete clearance of the calculus and normal urinary parameters. This case suggests a potential role of the Ayurvedic approach in the management of ureteric calculi of significant size; however, the findings are limited to a single case and should be interpreted with caution.