CPT® Code 53410

The procedure described by CPT® Code 53410 refers to a urethroplasty, specifically a one-stage reconstruction of the male anterior urethra. This surgical intervention is primarily performed to address strictures or obstructions in the anterior urethra, which can occur due to trauma, injury, or other pathological conditions. The anterior urethra is anatomically divided into three segments: the bulbar segment, which traverses the proximal corpus spongiosum and extends to the penile plane; the penile segment, which runs along the length of the pendulous penis; and the fossa navicularis, located at the glans penis. During the procedure, a catheter or urethral sound is utilized to accurately identify the location of the stricture. A Foley catheter is then inserted transurethrally into the bladder to facilitate access and visualization. The surgical approach involves making a midline incision along the ventral penile plane, followed by dissection through Buck's fascia to expose the urethra adequately. The stricture is incised over the catheter, and healthy urethral tissue is identified by extending the incision both distally and proximally. An onlay flap technique is employed, where a skin margin is excised to create a flap that will be used to reconstruct the urethra. This flap is carefully tailored to ensure that it fits the size of the urethral defect, and meticulous attention is given to the suturing process to minimize tension during closure. The procedure concludes with the placement of drains if necessary, and the transurethral catheter is left in place to support healing and maintain urethral patency postoperatively. This comprehensive approach aims to restore normal urethral function and alleviate any obstructive symptoms associated with the stricture.