title: Glans approximation procedure urethroplasty for the wide, deep meatus.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: G K
authors.initials: GK
authors.lastname: Gittes
authors.forename: C L
authors.initials: CL
authors.lastname: Snyder
authors.forename: J P
authors.initials: JP
authors.lastname: Murphy
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D010413:Penis / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods