CPT® Code 0582T

Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative imaging and needle guidance

Transurethral water vapor thermotherapy is a minimally invasive procedure designed to treat malignant prostate tissue by utilizing the thermal energy generated from steam. This technique aims to alleviate lower urinary tract symptoms associated with prostate malignancies. The procedure employs radiofrequency energy to convert small amounts of water into steam, which is then used to ablate the targeted prostate tissue. The process involves a unique method of heat transfer, specifically convective heat transfer, which is more effective than conductive heat transfer in this context. Patients typically receive oral pain medication or anxiolytics, and in some cases, conscious sedation is administered to ensure comfort during the procedure. A prostate block may also be utilized to enhance pain management. During the procedure, the patient is positioned in the lithotomy position, and a specialized hand-held delivery device is inserted into the urethra. This device is equipped with a lens that allows for direct visualization of the prostate tissue through cystoscopy. The needle is carefully positioned within the malignant tissue of the prostate, and a generator applies radiofrequency current to create steam, which is injected into the tissue. The steam rapidly condenses back into water, releasing energy that leads to the destruction of cancerous cells. The needle is adjusted and repositioned as necessary to ensure complete ablation of the targeted tissue. Over time, the body reabsorbs the ablated tissue, resulting in a reduction of prostate volume and an improvement in urinary function.