Urethrosphincteric reconstruction for congenitally absent urethra.

Three female patients with complete urinary incontinence owing to congenital absence of the urethra associated with complex congenital anomalies involving the caudal end of the urogenital sinus are reported. A sphincteric tube constructed from a flap of the anterior bladder wall was positioned in place of the missing urethra. Abundance of circularly oriented fibers in this neourethra provided sphincteric function sufficient to maintain continence and eliminate the need for urinary diversion. Details of the congenital anomalies and reconstructive techniques are discussed.