Urethral advancement and glanuloplasty UAGP vs. MAGPI for distal hypospadias repair.

Distal hypospadias is a commonly encountered anomaly. Since its innovation by Duckett the MAGPI procedure has become almost the standard operation for the correction of minor cases. Recently case selection has been advised to avoid possible complications and limitations. Between April 1986 and April 1995, 153 boys were treated for distal hypospadias. In 51 patients (coronal 31, subcoronal 20) a modified technique of urethral advancement and glanuloplasty (UAGP) has been used. The main indications of UAGP were the presence of glanular chordee (7), failed MAGPI (3), circumcised children with distal hypospadias (7), immobile fibrotic urethral meatus (5), and as an alternative to MAGPI (29). The overall complication rate was 4% compared to 3.8% with the MAGPI procedure which has been used in the treatment of 102 patients (glanular 50, coronal 47, and subcoronal 5). We feel this technique can be used effectively in patients with coronal and subcoronal hypospadias, particularly in the presence of distal chordee, fibrotic immobile urethral meatus or MAGPI limitations. Also UAGP could be a useful alternative to MAGPI where tension-free urethral advancement and glanular wrapping can be achieved.