CPT® Code 53850

Transurethral microwave thermotherapy (TUMT) is a minimally invasive procedure designed to treat benign prostatic hypertrophy (BPH), a condition characterized by the enlargement of the prostate gland that can lead to urinary difficulties. During this procedure, the patient remains awake and is positioned supine, allowing for easy access to the urethra. To ensure comfort, an antiseptic solution is applied to the penis, and a local anesthetic, typically 10-20 mL of 1-2% lidocaine gel, is instilled into the urethra. This local anesthesia helps to minimize discomfort during the procedure.

A specialized catheter is then inserted through the urethra and advanced to the bladder, where it is secured in place with a balloon tip. This catheter is equipped with a microwave antenna that is strategically positioned within the prostatic urethra. The correct placement of the catheter may be confirmed using a transrectal ultrasound, which is a separate procedure that can be reported independently. Additionally, a temperature-monitoring probe is placed in the rectum to ensure that the temperature during the procedure remains within safe limits.

Once the setup is complete, the microwave thermotherapy machine is activated, initiating the treatment. The microwave currents generated by the antenna raise the temperature of the prostate tissue to above 45 degrees centigrade, effectively destroying the excess tissue that contributes to BPH symptoms. To protect the surrounding urethral tissue from thermal damage, water circulates through the catheter, cooling the urethra throughout the procedure. The entire process typically lasts between 30 to 60 minutes, during which the patient is closely monitored for any signs of pain or discomfort. Upon completion of the treatment, the catheter used for the microwave therapy is removed and replaced with a Foley catheter, which is inserted transurethrally to facilitate urinary drainage during the recovery period.