Vascularization of the prepuce is crucial for hypospadias repair. Identification with high precision is achieved by the illumination technique. This method helps create the best vascularized flaps, whether longitudinal, oblique or spiral.

The effect of botulinum is transitory. However, it can break the circle of detrusor-sphincter dyssynergia and the period when it is sustained can be used for retraining the patient in normal voiding. At this moment botulinum-A toxin is one of last options in refractory cases of voiding dysfunction.

Closed reduction with percutaneous pinning is the method of choice in the treatment of displaced pediatric supracondylar humeral fracture, while open reduction with K-wire fixation is as a good alternative in cases with clear indications.

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Enlargement and sculpturing of a small deformed glans are challenging and difficult. A double-faced island flap and/or injection of hydrogel resolves this problem satisfactorily.

Morphological characteristics correlated with vascularization of the hypospadiac prepuce. Underdeveloped prepuces and those with unfavorable vascular pattern used for urethroplasty had a higher percentage of complications. In severe hypospadias the anatomical features of the prepuce have greater influence on the proper choice of 1 or 2-stage repair.

OBJECTIVE To assess the early disclosure and treatment of meatal stenosis after hypospadias repair, using calibration of the neourethral meatus at regular intervals to detect stenosis, and to assess the curative effects of dilatation with topical corticosteroids. PATIENTS AND METHODS Between 2001 and 2003, 83 boys (median age 19 months, range 12–28) had a proximal hypospadias repair using a tubularized skin island‐flap urethroplasty. The neourethra was calibrated every 7–15 days with newly designed small and fine metal sounds (5–12 F) for 3 months starting 7–10 days after surgery. The patients with meatal stenosis were treated by dilatation using topical 0.05% betamethasone cream daily (twice per day) for 3 months. RESULTS The mean (range) follow‐up was 29 (12–37)  months; 19 patients who developed early stenosis were treated by dilatation with topical steroids. After treatment, 14 neourethras were passable with a minimum sound of 10 F at regular 6–12 months assessments. Stenosis persisted in five patients who did not respond to the treatment; of these, a diverticulum developed in one and a fistula in two. All patients with permanent complications were re‐operated. There were no adverse effects in any of the patients treated with topical 0.05% betamethasone cream. CONCLUSION Early calibration and dilatation of the neourethra after hypospadias repair is a useful method for the early disclosure and treatment of meatal stenosis. The newly designed sounds made calibration/dilatation less unpleasant and more acceptable for the patient. Topical corticosteroids improved scar elasticity, which facilitated dilatation and prevented the formation of meatal stenosis.