Sudden Burning or Painful Urination Can Be More Than a UTI: Medullary Sponge Kidney

By Dr. Aimee Anagnostos, PT, DPT on 1/16/2023

Burning or pain with urination? Blood in urine? Relief with antibiotics? These symptoms can resemble a UTI or a lesser known diagnosis called Medullary Sponge Kidney (MSK). MSK is a birth defect where changes occur in the tubules, or tiny tubes, inside a fetus’ kidneys. The defect presents as cysts in the tubules preventing urine from flowing freely. However, one may not experience symptoms until the teenage years or the 20s.

Symptoms can include:

• burning or painful urination

• pain in the back, lower abdomen, or groin

• cloudy, dark, or bloody urine

• foul-smelling urine

• fever and chills

• vomiting

Complications from urine blockage and presence of cysts can lead to 1) kidney stones, 2) chronic UTIs, and 3) blood in urine. These three symptoms are the current physical exam and clinical findings. Health care providers may utilize ultrasound, computerized tomography scans (CT scans), or intravenous pyelograms to confirm the diagnosis.

• Ultrasound - uses a transducer head to emit painless sound waves to bounce off soft tissue. The image produced from the sound waves will show calcium deposits or kidney stones.

• CT Scans - a contrast or dye is injected, meanwhile while the patient undergoes a multidimensional x-ray to show soft tissue structures such as the kidneys. CT scans can show expanded or stretched tubules.

• Intravenous pyelogram - a healthcare provider will inject a special dye/ contrast into the patient’s arm and the dye will make its way to the kidney. The dye will illuminate any blockage in the urinary tract, and the cysts show up as clusters of light.

Management and prevention can include:

• Proper hydration - to keep urinary tract and lining clear and healthy

• Reducing sodium intake - excess sodium releases calcium into the urine, therefore reducing daily salt intake can decrease kidney stone formation

• Decreased meat intake - animal proteins (eggs, meat, fish) have a tendency of increasing uric acid stones and calcium formation.

The current treatment for UTIs and kidney stones, which can be ascribed to MSK, tend to fall under the umbrellas of chronic pharmacology treatments or invasive procedures. Conservative treatments of mobility and nutrition can play a role in this condition. Soft tissue mobility can decrease tightness and inflammation of surrounding structures in the abdomen. Moving and stretching the appropriate areas can allow for better urine passage. More research is needed to shed light onto how physical therapy and manual techniques can ameliorate painful urination, lengthen muscles around the urethra, and mobilize the kidneys.

Please reach out to us here at the Pelvic Health Physical Therapy Center in Madison, NJ to set up an evaluation & assessment! Feel free to call us 908-443-9880 or email us at contact@pelvichealthnj.com.

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