MAGPI technique for distal penile hypospadias; modifications to improve outcome at a single center

Background: Hypospadias is the most common congenital anomaly of urogenital organs in boys. We reviewed our experience with modification in the meatal advancement and glanuloplasty incorporated (MAGPI) technique of hypospadias repair. We point out some modifications and outcomes of this technique in this study. Patients and Methods: We identified all patients who underwent modified MAGPI repair of the distal hypospadias by a single surgeon over a 10-year period. We performed a retrospective chart review by outdoor assessment postoperatively. We assessed parents' satisfaction with functional and cosmetic outcomes. Decision to undergo this type of repair was intraoperative, depending on position and mobility of the meatus, and the quality of periurethral tissue. We made some modifications in the original technique of the MAGPI including no trimming of the edge of the glans in granuloplasty, incorporation of the collar in the granuloplasty; leading to glans augmentation and taking stay suture over the ventral wall of the urethra with some perimeatal tissue. Results: Our study was a retrospective analysis. We collected data retrospectively and outcomes were assessed by the outpatient department visits in follow-up. We identified 150 patients, with a median age of 6 years (3–8 years). Position of meatus was glanular 90 (60%) or coronal 60 (40%). Chordee was minimal in our study and was corrected by only penile degloving. Urethral stenting was required in all patients for 3–4 days. There was no case of fistula, meatal regression, stenosis, mucosal prolapse, or second procedure. Cosmetic outcome was deemed satisfactory in 98% (147/150). Conclusion: In selected cases, our modifications in the MAGPI hypospadias repair provide excellent functional and cosmetic outcomes with minimal complications.