The GAP (Glans Approximation Procedure) for Glanular/Coronal Hypospadias

A modified glanuloplasty is described for the selective repair of glanular and coronal hypospadias with a wide, deep glanular groove and noncompliant urethral meatus. No urinary diversion is required, and cosmetic and functional results are excellent. A total of 24 children underwent the GAP (glans approximation procedure) during 20 months. Followup ranged from 3 months to 1.5 years with no evidence of meatal or urethral stenosis. One distal glanular fistula developed that required division of a 2 mm. skin bridge that separated the fistulous opening from the neomeatus.