Repair of extensive traumatic membranous urethral disruption with endourethroplasty and artificial sphincter: case report.

We report a case of extensive traumatic membranous urethral obliteration with a 4-cm gap that was successfully treated with a transperineal-transurethral puncture technique to reestablish urethral continuity in association with endourethroplasty to repair the long fibrotic gap. The injury also involved the bladder neck, and the patient had subsequent stress urinary incontinence. Because endourologic treatment of his stricture did not require mobilization of the bulbous urethra, an artificial sphincter was placed 13 months later without difficulty. The patient is continent and remains stricture free at 3 years. This case illustrates the potential of endourologic treatment for severe membranous urethral disruptions.