CPT® Code 0421T

Transurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included when performed)

The procedure described by CPT® Code 0421T involves transurethral waterjet ablation of the prostate, a minimally invasive technique aimed at treating benign prostatic hypertrophy (BPH) that results in lower urinary tract symptoms (LUTS) due to bladder outlet obstruction. This innovative approach utilizes water-jet hydrodissection, also known as aqua ablation, which employs a high-velocity stream of saline to selectively ablate prostate tissue. The procedure is guided by transrectal ultrasound imaging, allowing the surgeon to accurately map the target area and program a robotic system to ensure precise contours and depth of tissue removal. The use of electromechanical control enhances the precision of the ablation process, while real-time ultrasound guidance aids in monitoring the procedure's progress. Additionally, the water jet technique not only ablates glandular tissue but also collects it for laboratory analysis post-procedure. The procedure may necessitate additional interventions such as meatotomy, internal urethrotomy, and urethral calibration or dilation to facilitate access to the prostate. Furthermore, the inclusion of control of post-operative bleeding, as well as the potential use of a laser beam for surface coagulation and hemostasis, underscores the comprehensive nature of this procedure. It is important to note that vasectomy and cystourethroscopy are also included in the scope of this procedure when performed, highlighting the multifaceted approach to managing BPH and associated urinary symptoms.