CPT® Code 51575

Complete cystectomy, as described by CPT® Code 51575, is a surgical procedure that involves the removal of the entire bladder along with a bilateral pelvic lymphadenectomy. This procedure is indicated for various serious medical conditions, including malignant neoplasms, which are cancers that can affect the bladder, as well as severe radiation or chemical cystitis, which is inflammation of the bladder due to radiation or chemical exposure. Other indications for this surgery include refractory interstitial cystitis, a chronic condition causing bladder pain and frequent urination; hemorrhagic cystitis, characterized by bleeding in the bladder; neurogenic bladder disease, which affects bladder control due to nerve damage; severe incontinence; trauma to the bladder; fistulas, which are abnormal connections between the bladder and other structures; upper urinary tract obstruction; and refractory urethral stricture, a narrowing of the urethra that does not respond to treatment. The procedure typically employs an extraperitoneal approach when urinary diversion has been previously performed. The surgical technique involves making a low midline or transverse suprapubic incision to access the bladder, followed by a series of meticulous dissection steps to ensure complete removal of the bladder and associated lymph nodes, specifically targeting the iliac, hypogastric, and obturator nodes bilaterally.