CPT® Code 50727

The procedure described by CPT® Code 50727 involves the revision of a urinary-cutaneous anastomosis, which pertains to any type of urostomy. A urostomy is a surgical opening created to divert urine away from the bladder when normal urinary function is compromised. This revision procedure is necessary when complications arise from the initial urostomy, which may include issues such as constriction or obstruction of the stoma, prolapse of urinary tract tissue through the stoma, retraction of the stoma below the skin level, detachment from the skin, necrosis of the tissue, or the development of a parastomal hernia. The revision process typically begins with a skin incision made around the entire circumference of the existing urostomy. Depending on the specific circumstances, local release of any scar tissue or adhesions may be performed. In more complex cases, dissection may extend through the fascia and peritoneum, allowing for resection of the distal portion of the urinary tissue, which is then everted and sutured back to the skin and subcutaneous tissue. If relocation of the stoma is required, the abdomen is opened at the new site, adhesions are lysed, and the exteriorized urinary tissue is mobilized. Any necrotic tissue is excised, and the terminal end of the urinary tissue is brought through the abdominal wall, folded back on itself, and sutured to the skin and subcutaneous tissue to ensure proper function and healing of the urostomy.