CPT® Code 51920

The procedure described by CPT® Code 51920 involves the surgical closure of a vesicouterine fistula, which is an abnormal connection between the bladder and the uterus. This condition can lead to significant complications, including urinary incontinence and recurrent urinary tract infections. The surgical approach begins with an incision in the lower abdomen, allowing the physician to inspect the abdominal cavity and pelvis thoroughly. During the procedure, the vesicouterine space is carefully dissected using both sharp and blunt dissection techniques to locate the fistulous tract. Once identified, the tract is excised, and the openings in both the bladder and uterus are meticulously closed. To ensure proper healing and prevent future complications, omentum, a fold of peritoneum, is interposed between the bladder and uterus. After the closure of the fistulous openings, the bladder is filled retrograde to confirm that the repair is watertight, ensuring no leakage occurs. Finally, the abdominal wall and skin are closed in a layered fashion, promoting optimal healing. This procedure is distinct from CPT® Code 51925, which involves the closure of a vesicouterine fistula in conjunction with a hysterectomy, indicating a more extensive surgical intervention.