Glans approximation procedure urethroplasty for the wide, deep meatus
G K Gittes1, C L Snyder, J P Murphy
1Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, USA.
Objectives:
To assess the reliability, cosmesis, and complication rate of the glans approximation procedure (GAP).
Methods:
We reviewed 37 consecutive GAP urethroplasties performed at the Children's Mercy Hospital in Kansas City, Missouri over a 5-year period, performed by three different pediatric surgeons. All patients selected had a large, deep ventral groove, typically with a wide open urethral meatus.
Results:
The mean age was 18 months, with a mean follow-up of 28 months. Of the 37, there was one urethrocutaneous fistula that has since been easily repaired with good results. The parents have been very pleased with the results in all cases, with a straight and strong urinary stream. There was one episode of transient erythema, possibly representing an infection, which resolved after 3 days of oral antibiotics.
Conclusions:
The GAP is technically easy, reliable, and offers a relatively low complication rate for the repair of a very select group of patients with hypospadias with a deep ventral glanular groove and wide-mouthed meatus.
