CPT® Code 50810

Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis

Ureterosigmoidostomy is a surgical procedure that involves the diversion of urine from the ureters to the sigmoid colon, effectively creating a new bladder from a segment of the sigmoid colon. This procedure is typically indicated for patients suffering from various conditions that impair normal bladder function, such as bladder cancer, neurogenic bladder, radiation injury to the bladder, and intractable incontinence. The operation begins with an incision in the midline of the abdomen, allowing access to the peritoneal cavity. The small intestine is temporarily moved out of the surgical field to provide a clear view of the ureters, which are then carefully exposed and divided near their junction with the bladder. The ureters are ligated to prevent urine flow from the kidneys during the procedure. A segment of the sigmoid colon is selected and mobilized to create the new bladder. This segment is isolated, and the remaining parts of the sigmoid colon are reconnected to maintain bowel continuity. The newly fashioned sigmoid bladder is then connected to the ureters through a tunnel, allowing urine to flow from the kidneys into the sigmoid colon. The procedure concludes with the creation of a stoma, either abdominal or perineal, through which urine will be expelled, and the surgical site is closed in layers. This complex procedure requires careful planning and execution to ensure proper function and minimize complications.