Urethral lithiasis after phalloplasty

Female-to-male transsexual patient, 22 years old, with neophallus from radial forearm free flap (phalloplasty in March 2014), history of urethral fistula and urethral stricture 1 year later treated with surgical correction (fistulectomy) and suprapubic urinary diversion. Subsequently, he developed a new urethral stenosis located in the urethral anastomosis. Immediately proximal to the stenosis, there was a urethral dilatation (pseudodiverticulum) with a fibrous septum and several retracted stones. The stones were fragmented, the fibrous septum destroyed and the urethral stricture corrected, all with holmium laser. After 40 months of follow-up the patient shows satisfactory urinary flow with no signs of residual lithiasis or stricture.