Glans Approximation Procedure (GAP) for Distal Hypospadias Repair

Sin, Sang Hun; Park, Jae Sin

Abstract

PURPOSE: There are various methods for distal hypospadias repair. Although meatal advancement-glanuloplasty (MAGPI) has been popularly used, it is not suitable in cases of megameatus intact prepuce (MIP) or hypospadias with a wide, deep, glanular groove. We assessed the reliability, cosmesis and complication rates of the glans approximation procedure (GAP).
MATERIALS AND METHODS
22 patients with distal hypospadias, who had undergone a GAP, were evaluated based on their charts. The cases of MIP, glanular hypospadias and coronal hypospadias were 10, 10 and 2, respectively. All the patients had wide, deep, glanular grooves or wide fish-mouth meatus. Two patients had mild ventral skin chordee. The mean age of the patients was 13 years old, ranging from 1 to 40 years, and the mean follow up period was 26 months ranging from 3 to 48 months. A Foley catheter was inserted in 18 cases, for a mean of 4.2 days. The surgical outcomes were retrospectively evaluated.
RESULTS
In the 22 patients, there was one urethro-cutaneous fistula, which was repaired, with a good result. There were 2 temporarily weak streams, 2 urine retentions and one wound infection, which were all resolved with appropriate treatments. All patients were pleased with the cosmetic results, and had good straight urinary streams.
CONCLUSIONS
The GAP was technically easy and reliable, and showed low complication rates in selected patients with MIP hypospadias and hypospadias, with a deep glanular groove.