The Failed MAGPI: Management and Prevention

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 poor patient selection. None of these patients had chordee on intraoperative artificial erection. Five were treated successfully with a repeat MAGPI procedure and the remaining 3 required a Mathieu procedure. Although best indicated for mild degrees of anterior hypospadias, the success of the MAGPI procedure still requires meticulous technique and proper patient selection.