Meatal Advancement and Glanuloplasty (MAGPI) Procedure

Abstract

Hypospadias reportedly occurs in about 1 in 125 male newborns (Sweet et al. 1974; Paulozzi et al. 1997). Recent evidence suggests that the incidence and severity of hypospadias has increased over the past 30 years (Paulozzi et al. 1997). This is thought to be a result of multiple factors, including exogenous hormone usage during gestation and environmental pollutants. About 50–70% of cases of hypospadias are classified as distal or anterior, when the meatus is located in a glanular, coronal or subcoronal location. In the past, surgical correction of these distal defects was not undertaken due to the morbidity involved with urethroplasties. It was considered that the minimal functional and cosmetic defects suffered did not warrant the potential complications of the corrective procedures. Improved surgical techniques and the increasing concern expressed by parents and older patients about appearance have changed prevailing attitudes in favor of surgical correction. Duckett, in 1981, described the meatal advancement and glanuloplasty or MAGPI procedure for the repair of distal hypospadias, renewing interest in this challenging endeavor. Since its initial description, the MAGPI operation has been performed worldwide in its original form as well as in multiple variations.