Urethral stricture is a common and complex disease in urology, which seriously affects the quality of life of patients and poses challenges to clinical treatment. Urethral reconstructive surgery has evolved from palliative approaches such as dilation and internal urethrotomy to systematic reconstruction based on flaps and mucosal grafts. With the introduction of oral mucosa and its histological compatibility, autologous mucosa has become the mainstay urethral substitute, while flaps remain indispensable in extensive and complex cases due to their robust vascularity. Advances in various fields of study have had a significant impact on the philosophy of surgery. The new approach has placed a higher value on anatomical structure and functional preservation alongside patency rates. This shift in focus has led to an increased importance of non-discontinuous anastomosis. Particularly in the repair of urethral injuries following pelvic fractures, Chinese scholars have utilized extensive case series to pioneer innovations in pediatric cases, complex obstructions, and combined fistula repair, thereby enriching global expertise. Concurrently, there is a growing interest in the exploration of tissue engineering and novel biomaterials for urethral repair. These approaches, ranging from the submucosal matrix of the small intestine to biomimetic degradable scaffolds, cellloaded engineered mucosa, and 3D-printed materials, are progressively entering clinical validation phases. In summary, urethral reconstruction is undergoing a shift from “reconstructing anatomy” to “balancing function.” Driven by precision medicine and regenerative medicine, it is expected to achieve more optimal individualized treatments in the future.

The high pressure generated from urinary tract obstruction can cause damage to the tissues and cells of the urinary tract. Persistent damage can induce urinary tract fibrosis, ultimately resulting in the loss of urinary tract function and severe clinical problems. In recent years, the role of a novel mechanosensitive ion channel in urinary tract fibrosis, Piezo1, has drawn due attention. This review systematically summarizes the mechanisms of Piezo1. In upper urinary tract fibrosis, Piezo1 participates in fibrotic process through the Calcium-Calpain2-integrin β1-adhesion protein pathway and Piezo1-p38MAPK-YAP signaling pathway. In lower urinary tract fibrosis, Piezo1 mediates bladder fibrosis via the YAP1 and TGF-β1/Smad pathways, and may contribute to prostate cancer-associated urethral obstruction through the Akt/mTOR signaling pathway. This study elucidates the critical roles of Piezo1 in urinary tract fibrosis, providing a theoretical foundation for developing novel Piezo1targeted therapeutic strategies. Future research can leverage advanced technologies such as microfluidic organ-on-a-chip system to explore the precise regulatory mechanisms of Piezo1, thus offering new insights for the clinical management of urinary stricture diseases.

Objective To investigate the efficacy of subcutaneous flap and/or pedicled penile skin flap combined with advancement flap coverage technique in the treatment of urethrocutaneous fistula(UCF)secondary to failed repair and to improve the success rate. Methods The clinical data of 36 UCF patients after urethral repair admitted to our hospital during Jan. 2020 and Jan. 2024 were retrospectively analyzed. According to the location and surrounding condition of the fistula, the fistula was closed without tension, the subcutaneous flap and/or pedicled penile skin flap was combined with advancement flap coverage technique. The effects of the treatment were followed up. Successful repair was defined as unobstructed urination, no recurrence of fistula and no urethral stricture. Results The patients' age was(25.7±11.6)years, and the diameter of fistula was(8.1±2.2)mm. UCF occurred in 24 cases after hypospadias repair, and in 12 cases after the repair of other urethral injuries, including 2 cases of urethral compression injury after improper indwelling catheterization, 2 cases of urethral stone removal, 2 cases of urethral diverticulum repair, 2 cases of circumcision repair, 1 case of congenital anal atresia repair, and 3 cases of other urethral repair. The primary repair success rate was 83.3%(30/36). Among the 6 patients with unsuccessful primary repair, 3 were cured with a secondary repair, 1 was cured after wound dressing, and 2 were lost to follow-up. The primary repair success rates of penile shape, penile scrotal junction, and perineal urethral skin fistulas were 82.1%(23/28), 83.3%(5/6), and 100%(2/2), respectively. The primary repair success rates for fistulas with diameter ≤1.0 cm and＞1.0 cm were 85.2%(23/27)and 77.8%(7/9), respectively; for single and two urethrocutaneous fistulas, the success rates were 84.8%(28/33)and 66.7%(2/3); for patients with 1 and ≥2 previous repair attempts, the success rates were 87.5%(14/16)and 80.0%(16/20). During the follow-up of(15.1±3.5)months, no recurrence of fistula occurred, and all patients experienced unobstructed urination with a maximum urinary flow rate of(19.5±4.2)mL/s. Conclusion The failure rate of UCF repair is still high. Based on the location of the fistulas and the condition of the surrounding tissue, the surgical success rate can be improved by utilizing subcutaneous flap and/or pedicled penile skin flap combined with advancement flap coverage technique. This approach allows for tension-free suturing and multi-layer closure of the fistula.

Objective:To investigate the treatment strategies for vesicovaginal fistula（VVF）in women following cervical cancer radiotherapy.Methods:A retrospective analysis was performed on the clinical data of 33 female patients with post-radiotherapy VVF after cervical cancer treatment at Shanghai Sixth People’s Hospital between January 2020 and June 2024. The patients were categorized into three groups based on surgical approaches：Group A（11 patients）：Underwent prone-position VVF repair. Mean age：（50.0±9.6）years；mean radiotherapy sessions：（22.6±2.2）. All had simple VVF without concurrent intestinal or surrounding soft-tissue fistulas. Among them，1 patient previously received laparoscopic VVF repair，1 transvaginal VVF repair，and 2 gracilis muscle flap packing for VVF repair. One month prior to surgery，the average daily usage of urine pads was 16.7（12.8，25.7）pieces，and the quality of life（QOL）score stood at 4.0（4.0，5.0）points. Preoperative cystoscopy revealed that 8 cases had fistulas located in the trigonal region of the bladder，while 3 cases had fistulas on the posterior bladder wall. The diameter of the fistula openings，measured under a microscope，was 1.2（0.8，1.6）cm. Based on the Goh classification criteria for vesicovaginal fistulas，this group included 3 cases of type 1，4 cases of type 2，2 cases of type 3，and 2 cases of type 4；7 cases of type A and 4 cases of type B；as well as 3 cases of typeⅠ，7 cases of type Ⅱ，and 1 case of type Ⅲ.Group B（20 patients）：Underwent gracilis muscle flap packing for VVF repair. Mean age：（58.6±8.8）years；mean radiotherapy sessions：（29.8±3.9）. Three patients had concurrent rectovaginal fistulas and received colostomy for fecal diversion. History of previous interventions：3 had laparoscopic VVF repair，4 transvaginal VVF repair，and 1 both transvaginal and laparoscopic VVF repair. One month prior to surgery，the average daily usage of urine pads was 19.7（15.8，27.7）pieces，and the QOL score stood at 5.0（5.0，6.0）points. Preoperative cystoscopy revealed that 13 cases had fistulas located in the trigonal region of the bladder，while 7 cases had fistulas on the posterior bladder wall. The diameter of the fistula openings，measured under a microscope，was 1.8（1.0，3.2）cm. Based on the Goh classification criteria for vesicovaginal fistulas，this group included 4 cases of type 1，9 cases of type 2，3 cases of type 3，and 4 cases of type 4；6 cases of type A，11 cases of type B and 3 cases of type C；as well as 1 cases of type Ⅱ，and 19 case of type Ⅲ. Group C（2 patients）：Underwent ureterocutaneous diversion. Ages：67 and 73 years；radiotherapy sessions：51 and 60，respectively. Both had concurrent rectovaginal fistulas and bladder soft-tissue fistulas. The patient presented with recurrent thigh abscesses accompanied by fever. One month prior to surgery，the daily usage of urine pads was 29 and 23 pieces，respectively，and the QOL score was 6 points. Cystoscopic examination revealed that the vesicovaginal fistulas were located in the trigone of the bladder，with diameters of 3 cm and 4 cm，respectively. Additionally，partial defects were noted in the ventral wall of the urethra，while no bladder soft tissue fistulas were detected. According to the Goh classification for vesicovaginal fistulas，both cases were categorized as type 4，type C，and type Ⅲ. For Groups A and B，urinary catheters were indwelled for 3 weeks postoperatively，then removed to assess spontaneous urination and incontinence. QOL was evaluated，with a minimum 6-month follow-up. For confirmed postoperative VVF recurrence，re-repair was performed 3?6 months later based on patient preference. For Group C，double-J stents were placed in the ureters，and stoma bags were applied 3 days postoperatively. Stents were replaced every 1?2 months，with QOL assessment. Successful fistula repair in Groups A and B was defined as the absence of vaginal leakage confirmed by cystoscopy after six months of the procedure with no vaginal leakage. For Group C，surgical success was determined by the resolution of perineal urinary leakage and improvement in QOL.Results:All 33 patients completed surgery successfully. Group A：Follow-up duration：16.3（9.6，24.6）months. Surgical repair succeeded in 7 patients，with unobstructed spontaneous urination and no vaginal incontinence. Four patients had VVF recurrence：2 refused further treatment，and 2 underwent repeat gracilis muscle flap packing. One was successfully repaired，while one recurrence case refused further treatment. Group B：Follow-up duration：17.0（9.5，24.8）months（8?32 months）. Thirteen patients restored spontaneous urination without recurrence. Seven had recurrence：5 refused further surgery，and 2 underwent re-repair. One repair succeeded without incontinence，while one recurrence case refused treatment. Group C：Follow-up durations were 6 and 22 months. Perineum remained dry without incontinence（no urine pads needed），and no recurrence of thigh soft-tissue redness/infection occurred. QOL scores were 2 and 3，respectively.Conclusions:Post-radiotherapy VVF in women after cervical cancer presents complex and variable conditions. The primary goal of treatment should be to improve patients’ quality of life. Treatment approaches should be selected based on the complexity of urinary fistulas and local tissue conditions. In general，patients who are younger，have received lower doses of radiation therapy，present with smaller fistula diameters，have well-vascularized and elastic perifistular tissues，and have no concurrent tissue fistulas are candidates for prone-position VVF repair. Patients who do not meet the criteria for transvaginal repair，have a history of at least two previous repair attempts，or have concurrent vaginorectal fistulas require gracilis muscle flap packing for VVF repair. Patients with three or more types of concurrent tissue fistulas，extensive pale and inelastic perifistular tissues，and who are not amenable to repair surgery undergo ureterocutaneous diversion.

Objective:To explore the application value of transpubic access on female urogenital tract injury.Methods:A retrospective analysis was conducted on 15 female patients with urogenital tract injury caused by trauma admitted to our department from May 2020 to October 2024，all of whom were complicated urethral stricture or atresia，accompanied by urethrovaginal fistula or vaginorectal fistula. All patients underwent suprapubic vesicostomy before surgery，and 1 case underwent sigmoidostomy simultaneously. The mean age of the patients was（29.6 ± 3.2）years old，and the course of disease was 6-24 months. Preoperative urethrography and urethroscope showed the location of urethral stenosis，with proximal urethra stricture in 7 cases and distal urethra stricture in 8 cases. The average length of strictures was（2.8±0.2）cm. The urethral ultrasonography，magnetic resonance and CTU examination showed 8 patients were complicated with urethrovaginal fistula，and 1 patient was complicated with vaginorectal fistula. All patients underwent transpubic access and resection of symphysis pubis. According to the specific conditions of urethral stricture，7 of them underwent end-to-end urethral anastomosis，5 cases underwent bladder wall flap urethroplasty，3 cases underwent vulva flap urethroplasty，8 cases underwent urethral vaginal fistula repair，1 case underwent vagino-rectal fistula repair，and 7 cases underwent vaginoplasty during the operation.Results:All the 15 patients underwent successful operation without complication. After the catheter being removed 4 weeks after surgery，2 patients had urgent urinary incontinence and 3 patients had stress urinary incontinence. The bladder neck was reconstructed 3 months after surgery，the symptoms of urinary incontinence improved in 1 case，urinary incontinence remained in 2 cases，and pharmaceutical or physical therapy were continued. Two patients could not urinate normally after the catheter was removed and still carried the vesicostomy tube，waiting for further treatment. The other 8 patients had unobtrusive voiding after extubating，and were followed up for an average of（22.5±3.2）months. There was no recurrence of urinary fistula，and the average maximum urinary flow rate was（22.8±3.2）ml/s.Conclusions:The transpubic approach is a safe and effective way to treat female genital tract injury by different surgical methods according to specific conditions，especially for patients with severe trauma，poor local tissue conditions，complicated urethrovaginal fistula or vagino-rectal fistula.

Objective:To explore the application value of transpubic access on female urogenital tract injury.Methods:A retrospective analysis was conducted on 15 female patients with urogenital tract injury caused by trauma admitted to our department from May 2020 to October 2024，all of whom were complicated urethral stricture or atresia，accompanied by urethrovaginal fistula or vaginorectal fistula. All patients underwent suprapubic vesicostomy before surgery，and 1 case underwent sigmoidostomy simultaneously. The mean age of the patients was（29.6 ± 3.2）years old，and the course of disease was 6-24 months. Preoperative urethrography and urethroscope showed the location of urethral stenosis，with proximal urethra stricture in 7 cases and distal urethra stricture in 8 cases. The average length of strictures was（2.8±0.2）cm. The urethral ultrasonography，magnetic resonance and CTU examination showed 8 patients were complicated with urethrovaginal fistula，and 1 patient was complicated with vaginorectal fistula. All patients underwent transpubic access and resection of symphysis pubis. According to the specific conditions of urethral stricture，7 of them underwent end-to-end urethral anastomosis，5 cases underwent bladder wall flap urethroplasty，3 cases underwent vulva flap urethroplasty，8 cases underwent urethral vaginal fistula repair，1 case underwent vagino-rectal fistula repair，and 7 cases underwent vaginoplasty during the operation.Results:All the 15 patients underwent successful operation without complication. After the catheter being removed 4 weeks after surgery，2 patients had urgent urinary incontinence and 3 patients had stress urinary incontinence. The bladder neck was reconstructed 3 months after surgery，the symptoms of urinary incontinence improved in 1 case，urinary incontinence remained in 2 cases，and pharmaceutical or physical therapy were continued. Two patients could not urinate normally after the catheter was removed and still carried the vesicostomy tube，waiting for further treatment. The other 8 patients had unobtrusive voiding after extubating，and were followed up for an average of（22.5±3.2）months. There was no recurrence of urinary fistula，and the average maximum urinary flow rate was（22.8±3.2）ml/s.Conclusions:The transpubic approach is a safe and effective way to treat female genital tract injury by different surgical methods according to specific conditions，especially for patients with severe trauma，poor local tissue conditions，complicated urethrovaginal fistula or vagino-rectal fistula.

Objective:To investigate the treatment strategies for vesicovaginal fistula（VVF）in women following cervical cancer radiotherapy.Methods:A retrospective analysis was performed on the clinical data of 33 female patients with post-radiotherapy VVF after cervical cancer treatment at Shanghai Sixth People’s Hospital between January 2020 and June 2024. The patients were categorized into three groups based on surgical approaches：Group A（11 patients）：Underwent prone-position VVF repair. Mean age：（50.0±9.6）years；mean radiotherapy sessions：（22.6±2.2）. All had simple VVF without concurrent intestinal or surrounding soft-tissue fistulas. Among them，1 patient previously received laparoscopic VVF repair，1 transvaginal VVF repair，and 2 gracilis muscle flap packing for VVF repair. One month prior to surgery，the average daily usage of urine pads was 16.7（12.8，25.7）pieces，and the quality of life（QOL）score stood at 4.0（4.0，5.0）points. Preoperative cystoscopy revealed that 8 cases had fistulas located in the trigonal region of the bladder，while 3 cases had fistulas on the posterior bladder wall. The diameter of the fistula openings，measured under a microscope，was 1.2（0.8，1.6）cm. Based on the Goh classification criteria for vesicovaginal fistulas，this group included 3 cases of type 1，4 cases of type 2，2 cases of type 3，and 2 cases of type 4；7 cases of type A and 4 cases of type B；as well as 3 cases of typeⅠ，7 cases of type Ⅱ，and 1 case of type Ⅲ.Group B（20 patients）：Underwent gracilis muscle flap packing for VVF repair. Mean age：（58.6±8.8）years；mean radiotherapy sessions：（29.8±3.9）. Three patients had concurrent rectovaginal fistulas and received colostomy for fecal diversion. History of previous interventions：3 had laparoscopic VVF repair，4 transvaginal VVF repair，and 1 both transvaginal and laparoscopic VVF repair. One month prior to surgery，the average daily usage of urine pads was 19.7（15.8，27.7）pieces，and the QOL score stood at 5.0（5.0，6.0）points. Preoperative cystoscopy revealed that 13 cases had fistulas located in the trigonal region of the bladder，while 7 cases had fistulas on the posterior bladder wall. The diameter of the fistula openings，measured under a microscope，was 1.8（1.0，3.2）cm. Based on the Goh classification criteria for vesicovaginal fistulas，this group included 4 cases of type 1，9 cases of type 2，3 cases of type 3，and 4 cases of type 4；6 cases of type A，11 cases of type B and 3 cases of type C；as well as 1 cases of type Ⅱ，and 19 case of type Ⅲ. Group C（2 patients）：Underwent ureterocutaneous diversion. Ages：67 and 73 years；radiotherapy sessions：51 and 60，respectively. Both had concurrent rectovaginal fistulas and bladder soft-tissue fistulas. The patient presented with recurrent thigh abscesses accompanied by fever. One month prior to surgery，the daily usage of urine pads was 29 and 23 pieces，respectively，and the QOL score was 6 points. Cystoscopic examination revealed that the vesicovaginal fistulas were located in the trigone of the bladder，with diameters of 3 cm and 4 cm，respectively. Additionally，partial defects were noted in the ventral wall of the urethra，while no bladder soft tissue fistulas were detected. According to the Goh classification for vesicovaginal fistulas，both cases were categorized as type 4，type C，and type Ⅲ. For Groups A and B，urinary catheters were indwelled for 3 weeks postoperatively，then removed to assess spontaneous urination and incontinence. QOL was evaluated，with a minimum 6-month follow-up. For confirmed postoperative VVF recurrence，re-repair was performed 3?6 months later based on patient preference. For Group C，double-J stents were placed in the ureters，and stoma bags were applied 3 days postoperatively. Stents were replaced every 1?2 months，with QOL assessment. Successful fistula repair in Groups A and B was defined as the absence of vaginal leakage confirmed by cystoscopy after six months of the procedure with no vaginal leakage. For Group C，surgical success was determined by the resolution of perineal urinary leakage and improvement in QOL.Results:All 33 patients completed surgery successfully. Group A：Follow-up duration：16.3（9.6，24.6）months. Surgical repair succeeded in 7 patients，with unobstructed spontaneous urination and no vaginal incontinence. Four patients had VVF recurrence：2 refused further treatment，and 2 underwent repeat gracilis muscle flap packing. One was successfully repaired，while one recurrence case refused further treatment. Group B：Follow-up duration：17.0（9.5，24.8）months（8?32 months）. Thirteen patients restored spontaneous urination without recurrence. Seven had recurrence：5 refused further surgery，and 2 underwent re-repair. One repair succeeded without incontinence，while one recurrence case refused treatment. Group C：Follow-up durations were 6 and 22 months. Perineum remained dry without incontinence（no urine pads needed），and no recurrence of thigh soft-tissue redness/infection occurred. QOL scores were 2 and 3，respectively.Conclusions:Post-radiotherapy VVF in women after cervical cancer presents complex and variable conditions. The primary goal of treatment should be to improve patients’ quality of life. Treatment approaches should be selected based on the complexity of urinary fistulas and local tissue conditions. In general，patients who are younger，have received lower doses of radiation therapy，present with smaller fistula diameters，have well-vascularized and elastic perifistular tissues，and have no concurrent tissue fistulas are candidates for prone-position VVF repair. Patients who do not meet the criteria for transvaginal repair，have a history of at least two previous repair attempts，or have concurrent vaginorectal fistulas require gracilis muscle flap packing for VVF repair. Patients with three or more types of concurrent tissue fistulas，extensive pale and inelastic perifistular tissues，and who are not amenable to repair surgery undergo ureterocutaneous diversion.

【Objective】 To explore the learning curve of single-surgeon robot-assisted laparoscopic radical prostatectomy (RARP), which provides a reference for physicians who intend to carry out RARP. 【Methods】 The clinical data of 65 prostate cancer patients who underwent RARP in our hospital during Sep.2022 and Dec.2023 were retrospectively analyzed.The patients’ median age was 67.5(58.1-82.4) years, median total prostate-specific antigen (PSA) was 15.6 (6.7-98.4) ng/mL, median body mass index (BMI) was 20.8(17.4-27.3) and preoperative clinical stage of tumor was T2aN0M0-T3bN1M0.The cumulative sum (CUSUM) method was used to fit the learning curves of machine installation time and operation time.According to the inflection points, the learning curves were divided into different learning stages, and the clinical data of patients at different learning stages were compared. 【Results】 The learning curve of RARP was 12 cases.The 65 cases were divided into three stages: 1st-12th cases in the learning stage, 13rd-43rd cases in the mastery stage, and 44th-65th cases in the proficiency stage.With the increase of the number of surgical cases, the median operation time [191(100-360) min vs. 116(83-165) min vs. 90(75-105) min] and median intraoperative blood loss [403(180-900) mL vs. 236(180-305) mL vs. 94(30-200) mL] in the three stages showed a gradual downward trend (P<0.05).The median machines installation time of the learning stage was significantly longer than that in the mastery stage and the proficiency stage [25(21-28) min vs. 12(11-15) min vs. 12(11-14) min] (P<0.05).The positive surgical marginrate (PSM) in the learning stage was significantly higher than that in the mastery stage and proficiency stage (41.7% vs.22.6% vs.22.7%) (P<0.05). 【Conclusion】 For surgeons with rich experience in traditional laparoscopic surgery, the learning curve of RARP is about 12 cases, and after 43 cases, the operation time and intraoperative blood loss can be further reduced.

Objective:To evaluate the efficacy of modified Kulkarni's one-stage tongue mucosal urethroplasty.Methods:From January 2020 to December 2022, 42 patients with anterior urethral stricture treated by modified Kulkarni one-stage tongue mucous urethroplasty in Shanghai Sixth People's Hospital. Stricture etiology was iatrogenic in 15 cases, trauma in 5 cases, unknown in 5 cases, infection in 6 cases, and lichen sclerosus in 11 cases. Twenty-one patients had previously undergone urethroplasty. The mean age of patients was (48.1±16.2) years. Median stricture length was (6.4±3.0)cm, including 11 cases with two strictures and 3 cases with multiple stenoses. The average preoperative Qmax was (4.6±2.3)ml/s, and the average residual urine was (96.6±24.7)ml. For treatment methods, a midline perineal incision was made, penis was invaginated into the incision, the distal extent of the stenosis was identified, urethra was rotated and dissected only on the left side, and incised dorsally to expose the whole stricture longitudinally. The tongue mucosal graft was fixed to the underlying albuginea and the right margin of the graft was sutured to the left margin of the urethral plate. Foley F14 silicon catheter was inserted. The urethra was rotated to its original position thus covering the oral graft. The improvements were as follows: First, we used tongue mucosa instead of cheek mucosa; Second, for the stenosis involving the urethral meatus, the narrowed urethral meatus was incised on the left side, which was continuous with the incision on the left side of the distal narrow segment, and then tongue mucosa was used as a whole. The catheter was removed 4 weeks after surgery, followed up 1, 3, 6 months, and then once a year.Results:All 42 patients underwent successful surgery without blood transfusion during the operation. The surgical time was 60-120 minutes. There were no complications such as infection, tissue necrosis, or bleeding during the perioperative period, and 16 patients complained of oral pain, which was relieved within one week after surgery. During the follow-up period, 39 cases presented with unobtrusive urination. One month after extubation, the maximum urine flow rate was (25.6±5.7)ml/s, and the residual urine volume was (11.3±7.1)ml. Three months after extubation, the maximum urine flow rate was (25.3±5.7)ml/s, and the residual urine volume was (11.9±7.5)ml. Six months after extubation, the maximum urine flow rate was (24.8±5.9)ml/s, and the residual urine volume was(12.4±7.9)ml. Two patients had recurrent stenosis 2 months after surgery, of which 1 patient underwent urethral dilation and recovered unobstructed urination, and 1 patient had recurrent stenosis after urethral dilation for 2 times and was cured after urethroplasty. No local wound infection, urethral shrinkage, urethral diverticulum, or urinary fistula occurred during the follow-up for 6 to 42 months.Conclusions:The modified Kulkarni’s one-stage tongue mucosa graft urethroplasty is suitable for most anterior urethral strictures, with high success rate, few complications, and avoidance of local wound complications

Female acquired urinary incontinence is a clinical challenge. This article reported a female patient who had urinary incontinence after excessive urethral caruncle resection. Urodynamics showed effective urethral length was 1.6 cm and maximal urethral pressure was 41 cm cmH 2O(1 cmH 2O=0.133 kPa). Urethroscopy showed urethral length was about 2 cm, urethral sphincter function was good, and urethral stricture was absent. The patient has undergone robot-assisted modified Leadbetter bladder neck reconstruction. The surgery was successfully completed without intraoperative complications. Urinary catheter was removed at 4 weeks after surgery, and the patient has complete urinary continence with unobstructed voiding. After 3 months of follow-up, the patient still has unobstructed voiding and urinary continence.