OUTCOME OF THE MODIFIED MAGPI PROCEDURE FOR PRIMARY REPAIR OF DISTAL HYPOSPADIAS

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%.