Tandem cuff artificial urinary sphincter (AUS) is a well-accepted treatment modality for refractory urinary incontinence following prostatectomy. We present a unique case of a 60-year-old male who experienced spontaneous urethral perforation between tandem AUS cuffs following a strong valsalva maneuver. The patient was treated with immediate AUS explant and transcorporal single cuff placement several months later.