Spinning top urethra on voiding cystourethrogram. | Zendy

Pankaj  Gupta | Zendy; Akshay Kumar Saxena | Zendy; Kushaljeet Singh Sodhi | Zendy

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Spinning top urethra on voiding cystourethrogram.

Author(s) -

Pankaj Gupta,

Akshay Kumar Saxena,

Kushaljeet Singh Sodhi

Publication year - 2014

Publication title -

urology journal

Language(s) - English

DOI - 10.22037/uj.v11i2.1911

Received March 2013 Accepted June 2013 Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. A 10-year-oldgirlwas referred foravoidingcystourethrogram(VCUG)withahistoryof recurrenturinary tract infections.Examinationincludingneurologicalevaluationwasunremarkable. Ultrasonographyofthekidneysandbladderwasnormal.VoidingphaseofVCUGwassubsequentlyperformed.Bladder capacityandoutlinewerenormal(Figure1).Therewasmarkeddilatationofposteriorurethra(Figure2)withsmoothtaperingtowards distalendresemblinga“spinningtop”.Novesicoureteralrefluxorpost-voidresidualurinewasnoted.Spinningtopurethra(STU) representsawidenedposteriorurethraseenmainlyingirls.Foralongtime,itwasconsideredanormalvariation,duetocontraction oftransversefibersofurethralsphincterlocatedinthedistalurethra.(1)ProponentsofSTUasapathologicalentityhaveattributedit variablytomeatalstenosis,urethralring,distalsphincterdyssynergia,bladderinstabilityandcongenitalwidebladderneckanomaly (CWBNA).(2)FormerthreemechanismswererefutedbystudiesshowinghighurineflowratesinsubjectswithSTU.Forthelattertwo mechanisms,controversyexistsbecausemajorityofcaseswithinstabilityandCWBNAdonotshowSTU.Thus,oneshouldconsider STUanormalvariant,sometimesoccurringinchildrenwithinstabilityorCWBNA.DifferentialdiagnosisincludesLyon1s(fibrous) ringingirlsandurethralvalvesinmales.(3) PICTORIAL

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