RATIONALE: Isolated urethral or anal sphincter complex injuries are rare in clinical practice, and combined traumatic injuries to both structures are extremely uncommon. The management of such complex injuries is highly challenging because it requires simultaneous reconstruction of urinary and anorectal functions. PATIENT CONCERNS: A 50-year-old male patient suffered from persistent perineal bleeding and severe pain for 40 minutes after a slip-induced impalement injury to the perineum. DIAGNOSES: Traumatic laceration of the bulbar urethra, anal sphincter complex injury, perineal soft tissue injury, and moderate anemia. INTERVENTIONS: The patient received one-stage surgery, including urethral repair, anal sphincter complex repair, perineal and anal plasty, and debridement and suture. Postoperative management included fasting, parenteral nutrition, defecation regulation, infection prevention, wound care, and anemia treatment. OUTCOMES: The perineal wound healed successfully. The patient recovered normal urination, fecal continence, and sexual activity. No severe complications, such as wound dehiscence, urethral stricture, or fecal incontinence, occurred. LESSONS: For patients with combined traumatic injuries of the urethra and anal sphincter complex, careful preoperative evaluation, mastery of local surgical anatomy, appropriate suture materials, and precise surgical techniques are essential. Meticulous postoperative care, including dietary management, defecation assistance, and strict wound hygiene, is critical for successful functional recovery.
Chen et al. (Fri,) studied this question.