OBJECTIVE: Urethrorrhagia after radical prostatectomy(RP) is very uncommon, regardless of the sur-gical approach used. Arterio-urethral fistula formation be-tween internal pudendal artery branches(IPA) and bulbar urethra is an exceptional finding. METHODS: We report what we consider the first series of two cases (one has already been published) of urethrorrha-gia after open retropubic RP due to urethrovascular fistula formation with its origin in the IPA or in one of its terminal branches.RESULTS: Both cases were diagnosed with contrast-en-hanced CT, confirmed with arteriography, and they were treated with superselective transarterial embolization(STE) with spongostan. After 5 years, the first case maintains erectile function using tadalafil on demand. The other case is in the 2nd postoperative month.CONCLUSION: Severe urethrorrhagia after RP is an ex-ceptional complication. The existence of an arterio-urethral fistula must be considered when both urethrorrhagia and abnormal bulbar enhancement in CT are present. Arteriog-raphy allows to confirm the diagnosis, most frequently in-volving IPA distal branches. STE is an effective and safe treatment.