The urinary meatus is the opening or meatus of the urethra on the penis, and in case of males is the common pathway for exit of both urine and semen. The meatus is usually supposed to be located at the terminal tip of the penis. However, sometimes its position may change, in a congenital condition (from birth) called hypospasdias.
What is Meatal Advancement and Glanuloplasty (MAGPI) Procedure ?
When the meatus is not located in its usual position, and is located in an abnormal position, a meatal advancement may have to be done. It is a reconstruction technique to restore the correct position of the meatus on the penis. The goal of each technique is to achieve a cosmetically normal, straight penis with a slit-like meatus at the tip, with a minimal complication rate and short hospitalization. The ideal method will be decided by your doctor based on meatal location and the appearance of the meatus relative to the penis. This procedure is most recommended for correction of distal hypospasdias (most common form of hypospasdias wherein the uretheral opening is found near or around the head of the penis).
What are the investigations to be done prior to a MAGPI procedure ?
The procedure involves first taking a urethrogram. This is basically an X-ray that shows the whole length of the urethra and assesses its course. It is performed by placing a very fine catheter inside the small tip of the urethra followed by injecting contrast medium (a dye that shows up on X-ray) whilst X-rays are taken. It gauges the length and course of the urethera.
How is the MAGPI procedure done ?
A pediatric urologist may advise the hypospadias surgery for the child between 6-24 months of age. On the other hand, the surgery can be performed at a later age. The surgery is frequently done on an outpatient basis. In very severe forms of hypospadias surgical repair has to be done in several stages. Most of the hypospadias reconstructive surgeries result in a penis that does well for both urinary and sexual purposes. The procedure will be done under a general anaesthetic. If you are given a general anaesthetic, your child will be sleeping during the procedure. Injection of antibiotics will be administered before the procedure, after you have been checked for any allergies. The penis wrap to support the new and advanced ventral urethral wall requires a solid tissue approximation in two layers to prevent the meatus from going back. Even meatal stenosis (narrowing) has to be avoided by assuring an adequate tissue rearrangement. A catheter will be placed in your child’s bladder and anchored to the head of the penis with stitches. This allows the urine to flow without coming into contact with the surgical repair. The skin will be closed with dissolvable stitches. The hospital stay can vary from between one to two nights.
What is the care needed to be taken of the site ?
Post procedure, it is essential for you to spread the opening out and apply ointment (an antibiotic ointment) three times all through the day, and at bath time as well for one week. This will prevent the new edges of the wound from joining back together. Sitting in a tub of clear, plain, warm water without soaps or bubble bath for 10 to 15 minutes each day helps heal the wound. This will keep the wound clean and prevent crusting. A small amount of antibiotic ointment can be placed on the diaper or the gauze pad in the underpants to keep the area from sticking.
Some swelling and bruising of the penis is definitely to be expected. This may last for upto several days. Bleeding into the urine also may be seen.
What are the end-results of this MAGPI Procedure ?
The complication rate is minimal. It particularly produces the esthetic appearance of a normal penis. The MAGPI procedure can be performed on an outpatient basis without any urinary diversion. The overall success rate with the MAGPI procedure suggests that it is an excellent procedure in the repair of distal hypospadias.
How to find and reach pediatric surgeons for MAGPI Procedure ?
Now you can find and reach pediatric surgeons for MAGPI Procedure from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple pediatric surgeons, get cost estimates for MAGPI Procedure from different hospitals, compare things and then choose a pediatric surgeon for MAGPI Procedure.
Find, reach and choose a pediatric surgeon for MAGPI Procedure on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
