One of the primary goals of the phalloplasty for female-to-male transsexuals is to gain the voiding ability in the standing position. However, fistula is one of the main complications. Prevention is the key to decrease the fistula. With the advance in modern medicine and science technology, the treatment of urinary fistula will be improved, for example, the development of tissue engineering provides a new pathway and opens up a wide prospect. In this paper, the causes and therapies of fistula after phallic reconstruction were reviewed.