In the last 20 years, endoscopic injection (EI) has affirmed as a valid alternative to open surgery for management of pediatric vesicoureteral reflux (VUR). This study aimed to investigate and discuss some debated aspects such as indications, bulking agents and comparison, techniques of injection and comparison, predictive factors of success, use in specific situations. EI is minimally invasive, well accepted by patients and families, with short learning curve and low-morbidity profile. It provides reflux resolution rates approaching those of open reimplantation, ranging from 69 to 100%. Obviously, the success rate may be influenced by several factors. Recently, it is adopted as first-line therapy also in high grade reflux or complex anatomy such as duplex, bladder diverticula, ectopic ureters. The two most used materials for injection are Deflux and Vantris. The first is absorbable, easier to inject, has lower risk of obstruction, but can lose efficacy over time. The second is non-absorbable, more difficult to inject, has higher risk of obstruction, but it is potentially more durable. The two main techniques are STING and HIT. To date, the ideal material and technique of injection has not yet clearly established, but the choice remains dependent on surgeon’s preference and experience.

Introduction: This study aimed to describe the available dressings and their management in patients undergoing hypospadias repair and compare post-operative outcomes with and without dressing and between the different dressing types. Materials and Methods: A comprehensive electronic literature search of PubMed, Embase, and Cochrane Library was conducted to obtain studies, published in the period 1990-2021, reporting on the dressing used following hypospadias surgery. All information regarding the dressing were considered as primary end points whereas surgical outcomes were assessed as secondary outcomes. Results: Thirty-one studies containing 1790 subjects undergoing hypospadias repair were included. Dressings were divided into 3 categories: non-adherent to the wound, adherent to the wound and glue-based dressings. Most authors preferred to remove/change the dressing in the ward and the median time of removal/change was 6.56 post-operative days. The dressing removal appeared as the most frequent factor generating parental anxiety. The median rate of wound-related complications was 8.18%, of urethroplasty complications 9.08% and of re-operations 8.18%. Metanalysis of outcomes showed higher risk of re-operations using conventional dressing, with no differences in urethroplasty and wound-related complications rates between conventional and glue-based dressings. Furthermore, use of dressing reported increased risk of wound-related complications compared with no dressing, without significant differences regarding occurrence of urethroplasty complications and re-operations. Conclusions: The current evidence confirmed that there is no difference in outcomes of hypospadias repair depending on a certain dressing type. To date, surgeon’s preference remains the main factor determining the choice for a specific dressing or for no dressing at all.