The cutaneous advancement procedure for megameatus and intact prepuce repair

Abstract

Megameatus and intact prepuce (MIP) is an unusual, anterior hypospadias variant characterized by a widely splayed coronal or subcoronal meatus, deep glanular groove, and normally conformed prepuce. This last finding can explain possible late recognition of the malformation. The MIP variant is not amenable to conventional repairs, and in recent years new types of repairs have been successfully developed. The author reports the results of a cutaneous advancement procedure (CAP) in 34 consecutive patients with the MIP variant of hypospadias. The procedure was successful in all patients with good cosmetic and functional results and without any discomfort during erection and intercourse. The CAP is a very simple and effective technique. It can also be done as an outpatient procedure and, in the author's experience, is particularly reliable for this unusual hypospadias variant.