Giant anterior urethral diverticulum with posterior urethral false passage masquerading as incontinence after pelvic fracture urethral injury: a case report

Male urethral diverticulum is a rare condition that poses significant management challenges when complicated by stenosis, false passage, and urinary incontinence. We report a 31-year-old male with refractory urinary incontinence following pelvic fracture urethral injury treated by primary urethral realignment. Chronic penile clamp usage led to progressive mid-urethral diverticulum enlargement. Imaging confirmed posterior urethral stenosis, diverticulum, and a sphincter-bypassing false passage. Surgical management included false passage obliteration, end-to-end urethroplasty, and diverticulectomy. At the 4-year follow-up, the patient has maintained unobstructed voiding and complete continence without recurrence throughout the follow-up period.