This document discusses principles of urethral reconstructive surgery. It covers general reconstructive considerations like tissue transfer and the anatomy and blood supply of skin and grafts. It also discusses the pathology of urethral strictures, principles of urethroplasty surgery including techniques like anastomotic urethroplasty and substitution urethroplasty. Important intraoperative considerations for urethroplasty are outlined such as positioning, urethral mobilization, and the use of instruments.