To evaluate the safety and efficacy of one piece urinary sphincter (ZSI 375) in patients with history of multiple lower abdominal surgeries. A 26 year old man presented with severe stress urinary incontinence since 19 years ago. At the age of 7, he suffered severe pelvic injuries due to a car accident and underwent multiple surgeries and a very large skin graft in the lower abdominal area. We used ZSI 375 as a one-piece urinary sphincter to prevent visceral injury because of scar tissue dissection. No complication was observed during one year follow up.