CPT® Code 52285

Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or trigone

CPT® Code 52285 refers to a cystourethroscopy procedure specifically designed for the treatment of female urethral syndrome. This syndrome is characterized by symptoms such as urinary frequency and pain during urination, which occur in the absence of a urinary tract infection or any identifiable urinary tract abnormalities. The procedure begins with the cleansing of the urethral orifice using an antiseptic solution to minimize the risk of infection. A rigid or flexible cystoscope, which is a thin tube equipped with a camera and light, is then carefully introduced through the urethra into the bladder. To enhance visualization of the bladder wall, sterile saline may be instilled into the bladder. During the cystoscopy, the physician inspects the bladder and identifies the ureteral orifices for examination. Following this, the cystoscope is gradually withdrawn to allow for inspection of the urethra. Depending on the findings observed during the cystoscopy, the physician may perform various therapeutic interventions. These may include urethral meatotomy or dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and/or fulguration of any polyps found in the urethra, bladder neck, or trigone area. If a stenosis (narrowing) of the meatus is detected, a meatotomy may be performed, which involves making an incision in the urethral meatus to widen it. In cases of urethral stricture, dilation techniques may be employed using progressively larger sounds, filiforms, and followers, or a balloon catheter to restore normal urethral diameter. Polyps located in the urethra, bladder neck, or trigone can be treated using an electrocautery device, which is advanced through the urethroscope to the site of the polyps. The device is activated to destroy the polyps, although alternative methods such as laser or cryoprobe may also be utilized for this purpose. Additionally, any fibrotic adhesions at the urethrovaginal septum may be severed as necessary, and transurethral relaxing incisions can be made at the bladder neck if indicated. Upon completion of the procedure, the bladder trigone, neck, and urethra are re-inspected with the cystoscope to ensure that any bleeding is controlled before the cystoscope is removed.