• Novel urethral microenvironment-adaptive hydrogel scaffolds, such as gelatin methacryloyl phenylboronic acid/cis-diol crosslinked hydrogels and alginate-nanohydroxyapatite-polysilane-silicon quantum dot composites, promote scarless repair and angiogenesis.
• Functionalized composites of decellularized extracellular matrix with synthetic/natural materials preserve bioactivity while improving mechanical properties and repair outcomes.
• Cell-free and intelligent scaffold strategies, such as exosome-loaded or engineered extracellular vesicle hydrogels, avoid risks of live cell transplantation and enable precise regulation of the repair microenvironment.
• Current challenges include mechanical mismatch with dynamic urethral environment, difficulty in coordinating degradation with tissue regeneration, and barriers to clinical translation and standardized production.