Objective: To determine the outcome of the modified MAGPI procedure for primary repair of distal hypospadias.
Methodology: This prospective descriptive study was performed in three hospitals of Bannu and Peshawar. A total of 24 cases with distal hypospedias were included in the study with coronal, subcoronal and glandular hypospadias. Those with chordee and more proximal forms where the MAGPI was not the procedure of choice were excluded from the study. The procedure of modified MAGPI included a modification of the original MAGPI (meatal advancement and glanuloplasty) by excision of a triangular shaped piece of glanular tissue or a vertical incision in the glans distal to the meatus. The patients were followed up for 6 months.
Results: The total number of patients who underwent modified MAGPI procedure was 24. The age range was 2- 10 years. The average length of hospitalization was 24 hours. Complications observed in 4 (16.6 %) cases. We observed two (8.3%) patients with meatus retraction and one (4.2%) with glanular dehiscence or total disruption and one (4.2%) with wound infection. No case with fistula was observed. Straightening of penis, good micturating stream and cosmetic outlook as well as parents satisfaction was achieved in 83.3% (n=20/24) cases.
Conclusion: Follow up of all the operated cases of the modified MAGPI procedure for primary repair of distal hypospadias showed good functional and cosmetic results. Complication rate was 16.7%.
Key words: MAGPI procedure, Hypospadias, Coronal
This article may be cited as: Rehman HU, Waheed T, Rehman IU, Imran M. Outcome of the modified Magpi procedure for primary repair of distal hypospadias. Khyber Med Univ J 2012; 4(4): 179-182.
Ahmed SF, Cheng A, Hughes 1A. Assessment of gonadotrophin
gonadal axis in Androgen insensitivity
syndrome. Arch Dis Child 1999; 80: 324-9.
Feyaerts A, Forest MG, Morel Y, Mure PY, Morel-Journel
N, Mallet D, et al. Endocrine screening in 32 consecutive
patients with hypospadias. J Urol 2002; 168: 720-5.
Stoll, C, Alembik Y, Roth MP, Dott B, Genetic and environmental factors in hypospadias. J Med Genet 1990;
Clup OS, McRoberts JW, Hypospadias; in Alken CE,
Editors. Encyclopedia of Urology. New York Springer.
V. 1968; 11307-113449.
Sulaiman AA. Repair of hypospadias in Mosul Paediatric
Surgery Centre (analysis of 125 cases). Ann Coll Med
Mosul 2008; 34(2): 109-17.
Duckett JW, Synder HM. The MAGPI hypospedias repair
in 1111 patients. Annals Surg 1991; 213(6): 620-6.
Taneli C, Genç A, Günsar C, Sencan A, Arslan OA, Daglar
Z, et al. Modification of meatal advancement and glanuloplasty
for correction of distal hypospadias. Scand JUrol Nephrol 2004, 38 (2):122-4.
Elemen L, Tugay M. Limited Urethral Mobilization Technique
in Distal Hypospadias Repair with Satisfactory Results. Balkan Med J 2012;29: 21-5.
Rasool M, Tabassum SA, Sheikh AH, Amin MM, Hypospadias
Repair. Professional Med J 2007; 14(4): 677-84.
Baran CN, Sungur N, Kílínç H, Ozdemir R, Sensöz O.
Incision Technique in Distal Hypospadias: A Modification
of Meatal Advancement and Glanuloplasty ©2002
American Society of Plastic Surgeons.
Alkan M, Oguzkurt P, Ezer SS, Ince E, Hicsonmez A. Evaluation of the results of eccentric circummeatal-based flap
with combined limited urethral mobilization technique for
distal hypospadias repair. J Pediatr Urol 2008; 4: 206-91.
Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology,
and technique. J Pediatr Surg 2006;41:463-72.
Rudin IuE, Anikiev AV, Shishkov MV.[Modification of
meatoglanuloplasty (MAGPI-Duckett) for treatment of
balanic and coronal forms of hypospadia in children].
Sommer JT, Stephen FD. Dorsal urethral Diverticulum of
fossa navicularis, symptoms, diagnosis and treatment.
J Urol 1980; 124:94-98.
Iqbal T, Uddin N, Khan M, Naz S. Frequency of complications in the Snodgrass repair and its risk factors. Pak
J Surg 2011;27(3):188-193.
Khan D. Management of hypospadias in children. J Surg
Khattak IU, Akbar M, Nawaz M, Al-Saleh A, Noor B, Ziaur-
Rehman. An audit of single stage hypospadias repair
at Ayub Hospital Complex, Abbottabad. J Ayub Med Coll
Duckett JW. Hypospadias repair in: O’Donnel and Koff
SA, Editors Pediatric Urology 3rd ed. Oxford: Butter
worth, Heinemann 1997: 551-568.
Kogan BA. Intra operative pharmacological erection as
an aid to pediatric hypospadias repair. J Urol. 2000 Dec;
Bianchi M: Correction of hypospadias. Arch Ital Urol
Androl. 1998 Dec; 70 (5): 219-22.
Man DW, Hamdy MH, Bisset WH. Experience with meatal
advancement and glanuloplasty (MAGPI) hypospadias
repair. Br J Urol 1984; 56(1):70-2.
Andersen B, Mitchell M. Recent advances in hypospadias:
current surgical technique and research in incidence
and etiology. Curr Urol Rep 2001;2(2):122-6.
Harrison DH, Grobbelaar AO. Urethral advancement
and glanuloplasty (UGPI): A modification of the MAGPI
procedure for distal hypospadias. Br J Plast Surg 1997;
Safwat A. Modified MAGPI for repair of distal hypospadias.
Benha M J 2004;21(1):709.
Jawad AJ. Urethral advancement and glanuloplasty
UAGP vs. MAGPI for distal hypospadias repair. Int Urol
Elbakry A. Management of urethrocutaneous fistula after
hypospadias repair, 10 year experience. BJU Int 2001;
Latifoglu O, Yavuzer R, Unal S, Cavasoglu T, Atabay K.
Surgical treatment of urethral fistula following hypospadias
repair. Ann Plast Surg 2000; 44(4):381-6.
Van-Savage JG, Palanca LG, Slaughenhoupt BL. A prospective randomized trial of dressing versus no dressing
for hypospadias repair. J Urol 2000; 164(3):981-3.
Oh Sumi N. Post operative compressive penile dressing
using fibrin seal (Tisseal) and tulle gauze for hypospadias
repair. Plast Reconstr Surg 1998; 101(6): 1737-8.
Holland AJ, Smith GH, Ross FI, Cass D. HOSE: An
objective scoring system for evaluating the results of
hypospadias surgery. Br J Urol Int 2001;88(3): 255-8.
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