[Optical internal urethrotomy after traumatic disruption of the urethra]

We report 4 cases of complete traumatic disruption of urethra treated by endoscopic management, core-through optical internal urethrotomy. A direct vision urethrotome was used to incise the totally obliterated urethra with transvesical endoscopic guidance and digital rectal or perineal control. Postoperatively, the patients required an average of 1.3 subsequent urethrotomies. The results were satisfactory in three cases and one case was under observation. All patients were continent and three of them were potent. We suggest that the endoscopic approach should be considered as an initial procedure for restoring urethral continuity prior to more extensive surgical repair.