CPT® Code 54318

The procedure described by CPT® Code 54318 refers to a urethroplasty specifically designed for the third stage of hypospadias repair, which is a surgical intervention aimed at correcting a congenital condition where the urethra does not open at the tip of the penis. In this particular stage, the goal is to release the penis from the scrotum, a condition that may occur in more severe cases of hypospadias. This stage is typically performed at least six weeks after the second stage of the repair to ensure that the neo-urethra has adequately healed and epithelialized, which is crucial for the success of the procedure. During the surgery, the patient is positioned supine, allowing for optimal access to the genital area. The surgical site, including the penis and scrotum, is meticulously prepared and draped to maintain a sterile environment. A Foley catheter is inserted transurethrally into the bladder to facilitate drainage during and after the procedure. The surgeon then carefully excises the approximated skin edges of the penis and scrotum, taking care to prevent any scrotal skin from being transferred to the penile shaft, which is essential for maintaining the integrity and appearance of the penis. The soft tissue of the penile shaft is preserved, and the edges of the penile skin are brought together and closed in the midline using absorbable sutures. The scrotal skin is similarly approximated and closed. Depending on the surgeon's discretion and the specific circumstances of the case, the Foley catheter may either be removed or left in place following the completion of the procedure.