Nuances of distal hypospadias.

The MAGPI procedure should be the procedure of choice and is applicable for most boys with coronal/subcoronal hypospadias. The excellent results of the MAGPI are reliable and reproducible. However, careful evaluation of meatal configurations is essential, as is assessing for the existence of fibrous chordee. Should subcoronal meatal variation or possible chordee exist, the creation of a vascularized meatal-based flap provides excellent flexibility as well as many options to the surgeon.