Pediatric Spinning Top Urethra

Etiology:
— Likely due to functional discoordinate voiding or bladder instability
— May also be a normal variant
Imaging:
— Non-obstructive dilation of the posterior urethra just distal to internal urethral sphincter mainly seen in females on VCUG exam,
— Can be seen during filling and voiding
DDX:
Complications:
Treatment: Behavioral modification of frequent and relaxed voiding
Clinical:

Radiology Cases of Spinning Top Urethra

CT of spinning top urethra — Coronal MIP simulating an intravenous pyelogram (above left), coronal (above right) and axial (below) CT urogram with contrast shows the right kidney to be duplicated. There were normal ureteral insertions bilaterally into the bladder (not pictured). There was an oval structure inferior to the bladder that appeared to be the posterior urethra.

VCUG showing spinning top urethra — AP image from a voiding cystourethrogram exam shows a non-obstructive ellipsoid-shaped dilation of the posterior urethra just distal to internal urethral sphincter.

VCUG of pediatric spinning top urethra — AP image from a voiding cystourethrogram exam during voiding shows a non-obstructive ellipsoid-shaped dilation of the posterior urethra just distal to internal urethral sphincter.