CPT® Code 0499T

Deleted

Cystourethroscopy, with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis, including fluoroscopy, when performed

Cystourethroscopy is a minimally invasive procedure that involves the examination of the bladder and urethra using a specialized instrument called a cystourethroscope. This procedure is particularly indicated for patients suffering from urethral stricture or stenosis, conditions characterized by the narrowing of the urethral lumen. Such narrowing can result from various factors, including injury, inflammation, infection, previous surgical interventions, catheterization, instrumentation, treatment for prostate cancer, or may even be congenital or idiopathic in nature. During the procedure, the patient is positioned in a dorsolithotomy position, which facilitates access to the urethra. The cystourethroscope is carefully inserted through the urethra and advanced into the bladder, allowing for a thorough inspection of the bladder's interior. Fluoroscopy may be utilized during this process to enhance visualization and capture images for further analysis. After inspecting the bladder, the cystourethroscope is withdrawn to examine the entire length of the urethra. To address the stricture or stenosis, a thin wire is introduced into the urethra, followed by the insertion of progressively larger dilators that mechanically widen the urethral lumen. Once dilation is achieved, the cystourethroscope is reinserted to identify the specific area requiring treatment. Therapeutic drug delivery is then performed, typically involving the injection of an anti-proliferative or anti-scar medication through the working port of the cystourethroscope. This injection aims to reduce the likelihood of scar tissue formation and promote healing. The procedure concludes with the removal of the cystourethroscope, ensuring that the targeted therapeutic intervention has been successfully administered.