neourethra

Neourethra refers to a surgically constructed urethral channel created to replace or augment the native urethra. It is used in several clinical contexts, most commonly in repair of hypospadias, where the urethral opening is not at the tip of the penis, and in gender-affirming phalloplasty, where a functional urethra is needed to urinate from a neophallus. It may also be employed after traumatic injury, congenital absence of the urethra, or severe urethral stricture.

Construction of a neourethra involves tissue grafts or flaps that form a tube-like channel. Common tissue sources include buccal mucosa from the cheek, penile or scrotal skin, and, less frequently, bladder or genital skin. Procedures can be single-stage or staged, depending on anatomy, tissue availability, and the reconstructive goals. The aim is to produce a durable, patent urethral lumen with a stable meatus and minimal risk of fistula or stricture.

Outcomes vary with technique and patient factors. Potential complications include urethrocutaneous fistula (an abnormal connection to the skin), urethral stricture or stenosis, diverticulum formation, hair growth within the reconstructed segment when hair-bearing skin is used, meatal stenosis, and infection. Long-term follow-up focuses on urinary flow, continence, cosmetic appearance, and, in transgender patients, functional urination and sexual function.

Neourethra represents a key component of complex urethral reconstruction, reflecting advances in tissue engineering and surgical planning to restore a functional urinary conduit.