Case characteristics: 1, male, 79 years old; 2, 7 years after suprapubic transcatheter prostatectomy, difficulty urinating, nocturnal incontinence for 3 years, with bilateral repeatable inguinal masses, urinary drip for 10 days; 3, prostate Ⅰ° large, soft tissue masses in the inguinal region bilaterally in the standing position, the outer ring is enlarged and can be retracted into the abdominal cavity, disappears in the lying position; 4, 18 Fr three-lumen catheter after urethral obstruction, need to bring a probe placed into the bladder; 5, ultrasound: right renal cortex a 2.5 × 2.6 cm cystic anechoic area, lower pole cortical thickness 1.6 cm. The right renal pelvis was dilated by 2.6 cm, the right ureter was dilated throughout, the left kidney was located in the left pelvis, and the ureter was not dilated. The inner wall of the bladder was not smooth and gross, and small atrial trabeculae were seen. A 3.0×2.5 cm echogenic area was seen above the bladder, communicating with the bladder, and the prostate was 2.5×3.3×3.5 cm . Intestinal tube-like echogenicity with peristalsis was seen in the bilateral inguinal masses during breath-holding, and normal breathing disappeared. Diagnosis: bladder neck sclerosis chronic urinary retention bladder diverticulum bilateral inguinal hernia right renal cyst left renal pelvic ectasia Treatment: transurethral plasma cystotomy under continuous epidural anesthesia. In the lithotomy position, the urethra was placed under direct vision with a 27Fr electrodesiccoscope, which showed a clear external urethral sphincter ring, a missing seminal frenulum, and a narrow bladder neck with only an orifice less than 1.0 cm in diameter and a grossly congested surrounding mucosa. The bladder neck was dissected at 5 to 7 points to the level of normal fibrous tissue of the bladder neck, triangle and posterior urethra, and by this time the bladder neck was patent. (Small atrial trabeculae were formed in all walls of the bladder with diffuse congestion of the mucosa and wide neck of the anterior wall diverticulum.) However, the bladder neck and prostatic fossa were markedly proliferated with fibrous scar tissue and there was a risk of recurrence of bladder neck stenosis if resection was not adequate. (In the past, there was a similar case of post-pubic transcystectomy prostate stenosis, repeatedly performed transurethral cyst neck incision in Beijing, Shanghai and other hospitals, after surgery are recurrent, and more and more serious, and finally no one in the local hospital dare to see again, only permanent cystostomy.) The prostate is then incised from 12 o’clock to the normal bladder neck fibrous layer, and the bladder neck, posterior urethral prostate fossa scar tissue and residual prostate tissue to the prostate peritoneum are removed on both sides respectively. A 22 Fr triple-lumen balloon catheter was left in place and removed one week after surgery. The patient urinated freely on his own without incontinence. Long-term results remain to be seen.