Background:
Complete bladder neck transection is a rare and complex urological injury, predominantly seen in pediatric populations, with limited guidance available for adult cases. Pelvic fracture urethral injuries (PFUI) commonly occur at the prostatomembranous-bulbar junction; however, isolated bladder neck injuries are exceedingly uncommon and pose significant management challenges.
Objective:
To present our experience with three adult cases of posttraumatic complete bladder neck horizontal transection, all managed with early surgical repair, and to assess postoperative outcomes.

Patients with post-traumatic bladder neck transection were studied and managed with early surgical repair to assess the postoperative outcome. 
Study design: 
Case series and comprehensive literature review.
Methods:
A detailed literature review was conducted to compile data on the surgical management of post-traumatic bladder neck transection. Patients were followed up in OPD to assess the outcomes.

Case Series:
Case 1: A 24-year-old male presented with blunt pelvic trauma following a train accident. He was unstable, with failed urethral catheterization and free fluid on FAST. Exploration revealed complete bladder neck transection. A suprapubic cystostomy was initially placed, followed by delayed primary repair after two weeks. Postoperative course was uneventful, and the patient remains continent and catheter-free at 3-month follow-up, with preserved physiological erections.
Case 2: A young male patient underwent immediate surgical exploration and primary repair of bladder neck transection at the time of injury following blunt pelvic trauma. The procedure involved a tension-free end-to-end anastomosis over a Foley catheter. Follow-up revealed complete continence, normal voiding function, and no evidence of stricture or complications.
Case 3: Another male patient presented within a week of sustaining pelvic trauma. Early surgical repair was performed within 7 days, with successful bladder neck to prostatic urethra anastomosis. The patient had a favorable postoperative recovery, remains catheter-free, continent, and has reported no complications to date.

The three cases were studied and outcomes were assessed in terms of continence, return to normal life, sexual dysfunction.

Conclusion:
Early or appropriately timed primary repair of complete bladder neck transection in adult males can result in excellent outcomes, including preserved continence and stricture-free healing. Our experience with three cases supports the feasibility and efficacy of early surgical intervention, particularly when a tension-free anastomosis can be achieved.