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, 2003). Finally, a stent or cathether malfunction can also rarely result in urine retention (Baskin et al., 1997). Infants are not the most cooperative http://www.selleckchem.com/products/Cyclopamine.html of patients and hypospadias repairs leave very exposed and vulnerable wounds. Manzoni et al. (2004) therefore recommend an open system with a dripping stent and double nappy method (see Figures 2�C4) to adequately contain the drained urine and prevent the child from interfering with the wound site. In older children, they prefer an indwelling Foley catheter (size 8F in a child to 12F in an adult). There is little agreement with the use of dressings in the literature as they can cause pain and even necrosis if applied too tightly (Sanders, 2002; Hadidi, 2004). Gormley et al. (2007) outline that a dressing is designed to protect the suture line, reduce swelling (oedema) and immobilize the penis over a period of 2�C10 days. Sanders (2002) also adds the rationales of avoiding bleeding, keeping the wound sterile, http://www.selleckchem.com/products/BI-2536.html holding the penis upright to minimize urethral trauma at the penoscrotal angle by stents as well as aiding lymph drainage and permitting visualization to allow early recognition of complications. Many types of hypospadias dressings have been tried, including silastic foam (Whitaker and Dennis , 1987) and elastic velcro dressings (Singh and Pavithran, 2004). Regardless of the type of dressing, removing them is associated with stress, anxiety and pain and requires considerable planning, often including a bath to soak off the dressing. Although this takes a good deal of time, especially in un-cooperative children, dressings are widely used. They are very likely to become wet from urine, wound exudate, soiling and sweat. Applying double nappies (Figures 2�C4) is therefore recommended to limit any soiling of the dressing. By using a non-stick barrier film to the skin and, at the time of removing the dressing, the application of an adhesive solvent to the tape Sanders et al. (2007) succeeded in reducing the time for removing the dressing. As the first bath ��can be an unpleasant experience��, Currie (2004) advocates using topical lignocaine 2% half an hour http://www.selleck.cn/products/gsk126.html before the bath, suggesting that it ��works wonders'. Two randomized controlled trials raise doubts over the need for dressings. Following hypospadias repairs of all severities undertaken as day cases Van Savage et al. (2000) found no difference between the boys with a transparent, gas permeable, waterproof, hypoallergenic non-latex sterile film dressing and those without a dressing in terms of success rate (90% in either group) or post-operative outcome. The only variation was a higher rate of post-discharge telephone calls (8 in 10 instead of 3 in 10) from the group of boys without a dressing. McLorie et al.