CPT® Code 51990

The procedure described by CPT® Code 51990 refers to a laparoscopic surgical technique known as urethral suspension for the treatment of stress incontinence. Stress incontinence is a condition characterized by involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercise. The laparoscopic approach involves making small incisions in the abdomen, which minimizes tissue trauma and promotes quicker recovery compared to traditional open surgery. During the procedure, a laparoscope—a thin, lighted tube with a camera—is inserted through a small incision below the umbilicus, allowing the surgeon to visualize the internal structures on a monitor. Additional small incisions are made to facilitate the introduction of specialized surgical instruments. The surgeon inspects the intraperitoneal cavity and carefully dissects the space of Retzius to locate and elevate the paravaginal fascia. This is crucial for placing sutures that will support the urethra and bladder neck, thereby restoring proper anatomical positioning and function. The procedure aims to elevate the urethrovesical angle, providing stability to the bladder neck and reducing episodes of urinary leakage. The effectiveness of the suspension is confirmed through visual inspection, manual assessment, or cystoscopy before concluding the procedure and closing the incisions.