Duckett J W, Snyder H M
Division of Urology, Children's Hospital of Philadelphia, PA 19104.
Ann Surg. 1991 Jun;213(6):620-5; discussion 625-6. doi: 10.1097/00000658-199106000-00012.
The meatal advancement and glanduloplasty (MAGPI) procedure was first described in 1981 for the repair of distal hypospadias. In the past decade, our experience has grown to more than 1000 procedures. An excellent surgical result requires careful case selection, avoiding cases with thin or rigid ventral parameatal skin or a meatus too proximal or too wide. The glans wrap to support the advanced ventral urethral wall requires a solid tissue approximation in two layers to prevent a retrusive meatus. Meatal stenosis can be avoided by assuring an adequate dorsal Heineke-Mikulicz tissue rearrangement and making an incision from within the urethral meatus well distally into the urethral groove. The MAGPI procedure routinely is performed on an outpatient basis without any urinary diversion. Our experience in 1111 cases during 12 years has required a second procedure in 1.2% of cases. The overall success rate with the MAGPI procedure suggests that it should continue to be used in the repair of distal hypospadias.
尿道口前移和阴茎头成形术（MAGPI）于1981年首次被描述用于修复远端尿道下裂。在过去十年中，我们实施该手术的经验已超过1000例。出色的手术效果需要仔细挑选病例，避免选择尿道外口腹侧皮肤薄或僵硬、尿道口位置过于靠近近端或过宽的病例。用于支撑前移的腹侧尿道壁的阴茎头包裹需要两层坚实的组织对合，以防止尿道口回缩。通过确保充分的背侧海涅克-米库利奇组织重排并从尿道外口向远侧在尿道沟内进行切口，可避免尿道口狭窄。MAGPI手术通常在门诊进行，无需任何尿液改道。我们在12年中对1111例患者的经验表明，1.2%的病例需要二次手术。MAGPI手术的总体成功率表明它应继续用于远端尿道下裂的修复。
