Features of UMS:
(1) An acquired ventral penile deviation occurs weeks after urethral catheterization or instrumentation. While it may occur after a single manipulation, most patients give a history of multiple urethral procedures.
(2) The penis is arched in the midline, with the glans directed downward when standing. The deviation is readily noticed during erection but may also be noted in the non-erect state.
(3) There is a palpable fibrosis present in the corpus spongiosum (spongiofibrosis).
(4) Periurethral fibrosis can be seen on ultrasonography, with some patients showing strictures, which may be multiple.
Variations:
(1) Only patients with significant scarring in the distal urethral will develop the deviation, and lesser degrees of fibrosis may be subclinical. Patients with fibrosis in the bulbous portion of the urethra do not develop the deviation.
(2) Some patients with periurethral inflammation may have a transient syndrome that remits as the inflammation subsides.
Differential diagnosis:
(1) Peyronie's disease: Fibrosis is present in the tunica albuginea of the corpora cavernosa, which can be seen on ultrasound.
