Posterior urethral stricture or atresia is overwhelmingly caused by urethral rupture or dissection due to pelvic fracture, and to a lesser extent by prostate surgery. Typically, the extent of damage from a pelvic fracture will determine the degree of bladder urethral displacement and the length of its posterior urethral stricture. Severe pelvic fractures not only result in complete separation of the posterior urethra, but also have the potential to damage the tissues and organs surrounding the urethra, such as the bladder and rectum, thus compounding the stricture. These compound injuries require a different treatment approach from the beginning and the final urethroplasty is often more complex.