CPT® Code 51840

The CPT® Code 51840 refers to the procedure known as anterior vesicourethropexy or urethropexy, which is commonly recognized by the names Marshall-Marchetti-Krantz or Burch procedure. This surgical intervention is primarily aimed at addressing urinary incontinence in women, a condition often resulting from the stretching of pelvic ligaments associated with vaginal wall prolapse. During the procedure, the surgeon makes an incision in the abdomen to gain access to the bladder neck and urethra, which are then carefully exposed. The technique involves suspending the prolapsed vaginal wall and urethra to restore proper anatomical positioning and function. To achieve this suspension, two sutures are strategically placed through the paravaginal fascia, positioned on either side of the urethrovesical junction and oriented perpendicular to the vaginal axis. These sutures are subsequently passed through supportive structures such as Cooper's ligament, pelvic fascia, or the pubic bone, and are tied securely to provide the necessary support to the bladder and urethra. In cases where additional support is deemed necessary, a second set of sutures may be introduced along the base of the bladder. This procedure is classified as a simple bladder suspension and is indicated for patients who have not undergone previous surgical interventions for this condition. For more complex cases, such as those involving a failed suspension procedure requiring secondary repair, the CPT® Code 51841 should be utilized instead.