The transgender male, after the construction of the neophallus, may present specific situations that require urological assistance by a specialist in urethro-penile reconstructive surgery. These situations are:

Urethral problems. Sometimes hair growth occurs inside the neourethra producing voiding difficulty, due to the growth itself and urethral strictures. Secondary urinary infections, requiring antibiotic treatments. How to avoid these problems? The ideal scenario is to prevent it, eiher at the time of the construction of the neophallus and the neourethra, using skin without hair follicle or rather with a specific treatment prior to surgery that prevents subsequent hair growth. If due to circumstances this problem appears, it may be necessary to indicate more invasive treatments, after infection has been treated. Temporary or definitive construction of a perineal urethrostomy (opening the native urethra to the skin of the perineum); alternatively, indicating a sequential urethral reconstructive surgery, removing the hirsute skin and replacing it with oral mucosa grafts, with subsequent tubularization. In any case, when this problem occurs, IT IS RECOMMENDED TO RESOLVE IT BEFORE THE IMPLANTATION OF A PENILE PROSTHESIS. We should prevent the appearance of recurrent urinary tract infections in transgender men with neophallus wearers of prostheses.

Desire for a penile prosthesis implant. It will allow the trans man to have sexual intercourse with active penetration, if that is he wishes. There are currently models of penile prostheses marketed with designs specifically adapted to the anatomy of the neophallus. Both malleable and hydraulic (inflatable) devices.

It is essential, to address these situations, to rely on a specialist with recognized expertise.