A year ago, a 19-year-old female patient came in with underdeveloped breasts, and after two surgical procedures, the patient changed from “female” to male. The patient was referred to the Department of Urology after examination: female perineal manifestation, but chromosomal analysis showed 46/xy. Diagnosis: pseudohermaphroditism, perineal hypospadias, and bilateral cryptorchidism. After full communication with the patient’s parents and understanding the patient’s sexual orientation, it was decided to change him to masculinity, and after his parents went to the Public Security Bureau to change his social gender, a phase I penile straightening and bilateral testicular descent fixation was performed. Recently, the patient was readmitted to the hospital to undergo a second-stage urethroplasty. The greatest difficulty of the operation is that the urethral defect is 12 cm long, and there is a serious lack of tissue available for urethroplasty, with a high failure rate and a complication rate of more than 50% for urethral stricture, urethral fistula and diverticulum. After Professor Shi Benkang presided over the whole department discussion, Associate Professor Zhang Dongqing and attending physician Zhou Changxuan carefully designed the operation and used multiple tipped flaps from the penis, scrotum and proximal urethra to form a new urethra during the operation. The success of this surgery marks a major step forward in the urethral subspecialty technology of the department.