In 1989, Zaontz described the GAP for distal hypospadias and reported a series of 24 patients.â The procedure was developed to avoid complications experienced with the meatal advancement and glanuloplasty procedure (that is, ventral glanular tilt, meatal retraction, and splaying of the urinary stream). Complications were noted in 48% of patients (15 of 31), including fistula (10), stricture (4), hematoma (2) and other complications (2). Forty-seven patients, who had this operation from 1985 to 1994, have been reviewed. It may be useful in the more distal types of hypospadias without chordee that present good skin quality. Out of these, 41 with proximal hypospadias with severe chordee required two-stage urethroplasty. 119 Open Inguinal Hernia Repair 471. Results: Ninety six patients involved in the study, the urethral meae were located coronally. functional neo-urethra. Since that time, the study of hypospadias has evolved into a subspecialty within pediatric urology, hypospadiology. meatal advancement and glanuloplasty (MAGPI) 8, transverse preputial island flap (TPIF) 9, parameatal based flap (Mathieu procedure) 8 and glans approximation procedure (GAP) 10. The primary drawbacks of the procedure are the complications of meatal regression and meatal stenosis. which are fistula and meatal stenosis. Duckett innovated meatal advancement and glanuloplasty (MAGPI) procedure and was applied for correction of this lesion. The procedure included degloving, correction of chordee, urethral mobilization and glans plasty. The technique has been modified considerably since it was first described in 1981. . In the past decade, our experience has grown to more than 1000 procedures. 1. Method: In this study we aimed to present our cases operated with either Meatal Advancement and Glanuloplasty (MAGPI) or Tubularized Incised Plate Urethroplasty (TIPU) procedures for coronal hypospadias. It was found that MAGPI can improve the position of the urethral meatus, correct meatal stenosis, release associated skin chordee and produce the aesthetic appearance of a normal penis. DOI: 10.4103/ais.ais_37_16 Background: Hypospadias is the most common congenital anomaly of urogenital organs in boys. Duckett, in 1981, described the meatal advancement and glanuloplasty or MAGPI procedure for the repair of distal hypospadias, renewing interest in this challenging endeavor. In this study, we discuss and evaluate our experience Glanuloplasty and in situ tubularization of the urethral plate is an excellent technique for the majority of boys with distal shaft and subcoronal hypospadias, producing a superior cosmetic result compared to the Mathieu procedure or meatal advancement and glanulopl surgery. METHODS: A total of 74 boys with anterior hypospadias underwent the procedure of urethral advance-ment and glanuloplasty (UAGP) with V flap of the glans in our medical centres between March 1994 and March 2000. Full text links Read article at publisher's site (DOI): 10.1016/s0022-5347(17)50218-9 The technique has been modified considerably since it was first described in 1981. A variety of techniques were used, including meatal advancement and glanuloplasty, meatal based flaps, island onlay flaps, Snodgrass repair and staged procedures. Summary— Of 142 patients with hypospadias seen at this institute over the past 2 years, 8 developed meatal regression following repair of their anterior hypospadias with the meatal advancement and glanuloplasty technique (MAGPI); 5 had meatal regression which was attributed to a technical failure and 3 had severe regression of the meatus with significant subcoronal positioning, suggesting . Since its initial description, the MAGPI operation has been performed worldwide in its original form as well as in multiple variations. 16 babies with unhealthy urethral plate and chordee were chosen for dorsal vertical tube Tubularised incised plate urethroplasty. 121 Transverse Preputial Onlay Island Flap 477. This procedure is done when the opening at the end of the boy's penis is too small or the shape of the hole distorts the urinary stream, making it difficult for him to urinate (pee). The choice of repair was made intra-operatively, depending on the position and mobility of the meatus and the quality of peri-urethral tissue. Duckett, in 1981, described the meatal advancement and glanuloplasty or MAGPI procedure for the repair of distal hypospadias, renewing interest in this challenging endeavor. The operative time for the Mathieu procedure was longer than that for the TIP and Duplay procedures, which did not differ. hypospadias repair was a meatal advancement and glanuloplasty procedure. Loading.. Other Articles in this issue of J. The overall complication rate was low with a 2.1% fistula rate and a 6.4% incidence of meatal retraction. These include meatal advancement glanuloplasty (MAGPI)I [4,5] and its modifications [6,7], glans approxi-mation procedure [8], and Koff [9] to mention a few. Deep, lateral mobilization of the distal part of the urethra is done in our institution for distal/coronal hypospadias followed by its advancement and glanuloplasty. Objective: The meatal advancement and glanuloplasty (MAGPI) technique is still successfully used for the repair of distal hypospadias. Dutta Accepted: 26 September 2012 / Published online: 7 March 2013 Springer-Verlag Berlin Heidelberg 2013 Abstract Keywords Hypospadias \u0002 Corpus spongiosum Objective Several procedures have been . Mustarde, meatal advancement and glanuloplasty (MAGPI) and tubularized incised plate (TIP) urethroplasty.1-4 Of these procedures Mathieu and Snodgrass urethroplasty (Snodgrass repair) have been widely practiced. Meatoplasty is a surgery in which the end of a child's penis is surgically opened and the edges are stitched together. Objectives: Evaluation of Mercedes Benz incision as a modification of the MAGPI procedure for repair of distal hypospadias with mobile meatus. Med. Meatal mobilization and glanuloplasty: A viable option for coronal and glanular hypospadias repair With an incidence of 1 in 300 male newborns. MAGPI - Meatal Advancement and Glanuloplasty Incorporated. Time and experience demonstrated that this technique could not be universally applied to all patients with distal hypospadias. The procedure included degloving, correction of chordee, urethral mobilization and glans plasty. Abstract English . Urethral surgery for hypospadias is accompanied by a relatively high number of complications and should therefore be carried out by surgeons with . The location of the urethral meatus was distal in 19 patients, mid shaft in 7, proximal in 4 and undetermined in 1. Seventy patients of distal penile hypospadias with age range 2-25 years were treated. Keywords 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. first described in 1981 by duckett, the meatal advancement and granuloplasty (magpi) technique is one of the most commonly performed hypospadias repair techniques that has withstood the stand of time.6,7it has a low complication rate (1.2% overall, 0.45 fistulas, no meatal stenoses) and reoperation is very seldom needed.8there are some concerns … meatal advancement and glanuloplasty operation: a simple surgical procedure designed to correct minor to moderate degrees of coronal or subcoronal hypospadias.This single-stage operation corrects any associated minor degrees of chordee and transfers the urethral opening to the glans. MAGPI: Meatal Advancement and Glanuloplasty Indication: distal hypospadias without chordee (no more than 1cm proximal to glans) Preop: make sure ventral skin proximal to meatus is thick and mobile - this allows it to be moved distally If perimeatal skin is poor quality, will need onlay repair Contraindication: don't do if meatus too proximal, if… Case selection is critical to surgical outcome. We report on 25 children who underwent repair of distal hypospadias with the meatal advancement and glanuloplasty technique. Pediatr Surg Int (2013) 29:633-638 DOI 10.1007/s00383-013-3292-x O R I G IN AL ARTI CL E Meatal and corpus spongiosum advancement: a better technique for distal hypospadias repair Hemonta Kr. urethral advancement and glanuloplasty (UAGP) was used, employing a V flap of the glans for glanuloplasty for distal hypospadias (including glanular hypospadias) with satisfactory outcome.18 In one study, children underwent double Y-type of glanuloplasty technique for correction of glanular site hypospadias. Complications were seen in 19 patients. Median patient age at first hypospadias surgery was 13 years. Dissatisfied with the results of the meatal advancement and glanuloplasty (MAGPI) and perimeatal-based flap procedure, they described the "pyramid procedure." Yet another technique designed to overcome the challenges of a wide, deep glanular groove and a noncompliant fish mouth procedure is the glans approximation procedure (GAP). The meatoplasty and glanuloplasty procedures developed by Duckett have become standard operations to correct these lesions. Meatal advancement and glanuloplasty has proved to be a successful and reliable procedure in the properly selected child with distal hypospadias. We retrospectively reviewed the patient records who had hypospadias repairing surgery between March 2017 and March 2020 in terms of age, meatal position, operative and anaesthesia techniques and . The primary drawbacks of the procedure are the complications of meatal regression and meatal stenosis. [Meatal advancement and glanuloplasty incorporated (MAGPI): a new surgical technic in the treatment of distal hypospadias] . Purpose: To evaluate the diagnosis and treatment methods of hypospadias with megameatus intact prepuce (MIP).Materials and Methods: A retrospective analysis was performed in 27 MIP children, 13 of whom underwent tubularized incised plate urethroplasty (TIP procedure), 7 underwent the Duplay procedure, 5 underwent the Mathieu procedure, 1 underwent meatal advancement and . The treatment of hypospadias has a long and colorful history dating back to AD 100-200, when Heliodorand Antyl is credited with the first surgical management. 3 In 1981, Duckett presented a meatal advancement and glanuloplasty (MAGPI) technique for subcoronal and glanular cases without chordee (Duckett1981). The goal of hypospadias surgery is to achieve a functional and a cosmetically normal penis. Meatal advancement and glanuloplasty has proved to be a successful and reliable procedure in the properly selected child with distal hypospadias. Meatal advancement and glanuloplasty (MAGPI) The MAGPI technique was described by Duckett in 1981 . A 1-day procedure was all that was required in 52 children (80 per cent). MAGPI was performed Subsequently, the difference in outcomes of the re-operative tubularized incised plate urethroplasty in relationship to the type of the original procedure was significant. The average age was 6,6. The common surgical procedures include: meatal advancement and glanuloplasty (MAGPI), the tubularised incised plate (TIP) technique according to Snodgrass, and vascularised foreskin flap-plasty. meatal advancement and glanuloplasty technique (MAGPI) was designed to reduce the risks of formal urethroplasty in distal hypospadias. 123 Ureteral Reimplantation: Extravesical Technique 485 At 3 The GAP eliminated the ventral glanular tilt, meatal retraction and splaying of the urinary stream that was seen at times in meatal advancement and glanuloplasty procedures. Two-stage . after retraction of the prepuce we inspected the stream and correcting this deformity, such as magpi (meatal advancement found that the distal meatal web caused the turbulent pattern. A total of 74 boys with anterior hypospadias underwent the procedure of urethral advancement and glanuloplasty (UAGP) with V flap of the glans in our medical centres between March 1994 and March 2000. In this method of repair, the apex . The meatal location may be anywhere from just below the tip of the glans to the perineum and hypospadias is divided into three types, posterior, middle and anterior, based on the position of the meatus. Results: Overall operative success rate observed in the study was 41 (85.41%) patients. In 1982, Baran used a modification of the Beck and Hacker technique by elongating the distal urethra to the tip of the penis through a surgically created tunnel (Baran and Cenetoglu 1993).A glanular triangular flap was used in the In 18 babies with glanular hypospadias, a meatal advancement and glanuloplasty procedure was done. Our aim was to review our experience with some modifications in the original MAGPI repair to reduce complications and improve outcome. 2. To evaluate the surgical outcomes of meatal advancement and glanuloplasty incorporation (MAGPI) and tubularised incised plate (TIP) urethroplasty. This will depend on; type of hypospadias, whether patient is After liberating the ventral skin, the surgeon performs a triangular suprameatal incision from the point where the new meatus is intended. Meatal advancement and glanuloplasty (Duckett 1981). The GAP eliminated the ventral glanular tilt, meatal retraction and splaying of the urinary stream that was seen at times in meatal advancement and glanuloplasty procedures. The longitudinal incision is sutured transversely, in Heineke-Mikulicz fashion. A modification of the meatal advancement and glanuloplasty technique (MAGPI), the urethral advancement and glanuloplasty (UGPI), is described. Suitable for very distal and mobile meatus with no chordee. Subsequently, the difference in outcomes of the re-operative tubularized incised plate urethroplasty in relationship to the type of the original procedure was significant. A variety of techniques were used, including meatal advancement and glanuloplasty, meatal based flaps, island onlay flaps, Snodgrass repair and staged procedures. The principles of this operation were safe and there were no complications. 5.2. (1984) modified the MAGPI technique to repair a more proximal meatus. Meatal stenosis incidence was 0.8%, and good cosmetic results with a natural-looking, anatomically placed meatus and a well-directed urinary stream during urination were achieved. Snodgrass being now the preferred method since it creates a vertical slit-like normal Objective To assess the results and complications of dorsal vertical island flap (DVIF) urethroplasty. Looking for abbreviations of MAGPI? In the presented series, GAP has been our choice of surgical treatment with excellent results. Methods A total of 175 children were operated on for hypospadias. This can be explained by the integrity of the urethral plate in these cases. The authors conclude that this technique, as recommended by several authors, is a simple, safe and effective procedure for distal hypospadias. 118 Megaureter Repair 467. Van Horn and Kass (1995) modified King's (1970) approach by extending the paraurethral incision to the tip of the glans penis and used a two layer ventral closure of the . Objective: The meatal advancement and glanuloplasty (MAGPI) technique is still successfully used for the repair of distal hypospadias. The most common immediate postoperative complication was hematoma seen in five (8.3%) cases; all patients with hematoma were managed conservatively. Complications occurred in 4 of the 25 patients (16.0%), and the overall complication-free survival rate at 1 year after surgery was 80.5%. It is Meatal Advancement and Glanuloplasty Incorporated. Objective: The meatal advancement and glanuloplasty (MAGPI) technique is still successfully used for the repair of distal hypospadias. Procedures established to correct distal penile hypospadias are the tubularized incised plate urethroplasty (TIP repair), Thiersch-Duplay, Mathieu's repair, Mustarde, Onlay flap, and meatal advancement and glanduloplasty (MAGPI). Of these procedures, Mathieu's and TIP urethroplasty (Snodgrass repair) have been widely practiced. After 2-3 weeks of surgery, four (6.6%) patients had narrow urinary stream and labeled as stenosis; these patients were man-aged with urethral dilatation weekly for 2 to 3 weeks. because this is the closest code for this portion of the procedure. Meatotomy is the surgical opening of the . 120 Transurethral Incision of Ureterocele 475. For the correction of the chordae, a dermal graft was the main procedure of choice. In 18 babies with glanular hypospadias, a meatal advancement and glanuloplasty procedure was done. Hypospadias repair should be done with minimal complications. Repair of hypospadias by meatal advancement and glanuloplasty incorporated technique (procedure) Repair of hypospadias urethroplasty using glanular flap (procedure) Simple one stage distal hypospadias repair with meatal advancement. The study was carried out from September 2006 to August, 2010 in the Department of Urology, Nawaz Sharif Social Security Hospital, Lahore. Longitudinal incision made between meatus and its intended position. Complications such as meatal stenosis, meatal retraction, and fish mouth-like meatus can be seen after meatal advancement and glanuloplasty ("MAGPI"), though it usually yields good results. Initial hypospadias repair In 25 babies with mid-penile and distal penile hypospadias, tubularized incised urethral plate (TIP) urethroplasty was the option. hypospadias repair was a meatal advancement and glanuloplasty procedure. for the meatal advancement and glanuloplasty (MAGPI) procedure. + Two stage reconstruction by urethra-terminalizing operation (procedure) A myriad of procedures for glanular hypospadias have been developed during the last 30 years based on the principle of urethral mobilization first described by Beck [3] in 1898. Meatal advancement and glanuloplasty: an operation for distal hypospadias Abstract We report on 66 children who underwent repair of distal hypospadias with the meatal advancement and glanuloplasty technique. redo surgery was carried out; in both cases, meatal ad-vancement glanuloplasty (MAGPI) procedure was per-formed. underwent meatal advancement and glanuloplasty incorporated (MAGPI) repair while in group B 15 (31.25%) patients underwent Tabularized Incised Plate (TIP) repair and 9 (18.75%) patients underwent combined TIP and Mathieu's repair. pyramid procedure, cutaneous advancement procedure, subcutaneous frenulum flap with many modifications, perimeatal based flaps, meatal advancement and glanuloplasty (MAGPI) technique and tubularized incised plate urethroplasty [3,5,8-14,19,20]. Modification of meatal advancement and glanuloplasty for correction of distal hypospadias Modification of meander migration by bank failures Modification of maillard browning in a microwaved glucose/glycine model system by water-soluble natural antioxidants and foods containing them Meatal advancement and glanuloplasty proved to be a successful and reliable procedure in the properly selected child with distal hypospadias. For the repair of the penile torsion, use 14040 (Adjacent tissue transfer or rearrangement.) During the last 10 years our experience has increased to more than 1,000 cases. We reviewed our experience with modification in the meatal advancement and glanuloplasty incorporated (MAGPI) technique of hypospadias repair. W-flap glanuloplasty, an addition to reconstructive surgeons' armamentarium, is applicable to most patients. While the meatal advancement and glanuloplasty incorporated (MAGPI) repair continues to give satisfactory outcomes, its critics have noted its association with meatal regression and meatal stenosis. This can be explained by the integrity of the urethral plate in these cases. Only one patient had wound infection. We retrospectively reviewed the patient records who . 3. Meatal Advancement and Glanuloplasty Incorporated - How is Meatal Advancement and Glanuloplasty Incorporated abbreviated? Cosmetic results were excellent in most patients. The technique has been modified considerably since it was first described in 1981. Introduction. In Western civilization the incidence of hypospadias is . Types of repair for urethral construction included; Glans Approximation procedure, (GAP); meatal advancement and glanuloplasty incorporated, (MAGPI); tubularized incised plate urethroplasty, (TIPU); Mustarde´; buccal mucosal tube tunnelled urethroplasty. Answer:You should report 54322 (One stage distal hypospadias repair.) TIP repair was appropriate for nearly all boys except for those with severe chordee or unsatisfactory plate integrity necessitating plate transection11. Two patients (5%) had retraction of the urethra for which redo surgery was carried out; in both cases, meatal advancement glanuloplasty (MAGPI) procedure was performed. Van Horn and Kass (1995) modified King's (1970) approach by extending the paraurethral incision to the tip of the glans penis and used a two layer ventral closure of the . History of ORL until the beginning of the 19th century. The meatal advancement and glanuloplasty procedure (MAGPI) and its modifications are commonly used for distal hypospadias repair ( Fig. 1). Some popular procedures include; glans approximation procedure (GAP), meatal advancement and glanuloplasty incorporated (MAGPI), tubularized incised plate urethroplasty (TIPU), Mustarde´, etc. Conclusions: Although retrospective in nature . We first described the meatal advancement and glanuloplasty (MAGPI) procedure in 1981 as a technique to repair distal hypospadias. Patients were followed for 1 to 10 years. The primary drawbacks of the procedure are the complications of meatal regression and meatal stenosis. 122 Tubularized Incised Plate Urethroplasty 481. Summary— Our experience with the procedure of meatal advancement and glanuloplasty (MAGPI) is reviewed with a note on the technique. Since its initial. The patients were followed up for 6 months. Brief urinary diversion was used in only 3 patients. These techniques include urethral mobilization (1898) 2, the Paulus technique (1993) and its modification 5, meatal advancement and glanuloplasty incorporated (1981) 6, glanular approximation procedure (1984) 7, tubularized incised plate (1994) and its modification 8 and meatal mobilization (2007) 9. Purpose: To evaluate the diagnosis and treatment methods of hypospadias with megameatus intact prepuce (MIP).Materials and Methods: A retrospective analysis was performed in 27 MIP children, 13 of whom underwent tubularized incised plate urethroplasty (TIP procedure), 7 underwent the Duplay procedure, 5 underwent the Mathieu procedure, 1 underwent meatal advancement and glanuloplasty (MAGPI . Arap et al. 2004; 3 (2): 131-136 . The most commonly practiced surgical procedures for hypospadias repair are MAGPI (Meatal advancement and glanuloplasty) for glanular hypospadias, Thiersch Duplay Mathieu, and Snodgrass (TIP procedure)[9]. Meatal advancement and glanuloplasty (MAGPI) was performed in 28 (29.1%) patients and tubularized incised plate urethroplasty (TIPU) in 68 patients (70.9%). Initial hypospadias repair analgesia rate, and cure rate among the three surgical procedures.
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