尿道狹窄的治療一直是泌尿科醫生的挑戰。今報告一骨盆腔骨折合並尿道球膜部斷裂病例。經多次內視鏡重建尿道連通性失敗，最後以尿道內切開術及擴張後植入2.5公分之自動擴張支撐器於2公分長之尿道狹窄段。經九個月後支撐器內近端長入結疤組織而致尿流注逐漸減小。雖經多次以內視鏡下切除結疤組織或尿道內切開術處理，均不能維持滿意的尿道連通性。最後病患接受經會陰取出支撐器並尿道狹窄段，然後施以尿道端吻合術而獲得滿意結果。我等認為使用植入尿道內自動擴張支撐器並不能完全解決尿道狹窄的問題。術前慎選病患及術後長期追蹤確有必要。

The management of urethral stricture is always a challenge to the urologists. Here we report a case who suffered from pelvic fracture and complete bulbomembranous urethral disruption. After several attempts the endoscopic means failed to restore his urethral continuity. A self-expandable urethral stent 2.5 cm in length was implanted for bulbomembranous urethral stricture 2 cm in length after visual internal urethrotomy and dilatation. The urinary stream decreased 9 months after the stent placement due to ingrowth of granulation tissue at the proximal end of stent lumen. Even endoscopic means for resecting scar tissue or internal urethrotomy could not keep the satisfactory results of urethral patency. Finally, the patient underwent transperineal removal of urethral stent with segmental resection of the stenosed urethra and end-to-end anastomosis one year after implantation with acceptable result. In conclusion, implant of urethral stent cannot resolve all the urethral obstructions. Preoperative selection of the patients and postoperative long-term follow-up are necessary.