CPT® Code 53210

A total urethrectomy in females involves the complete surgical removal of the urethra, which is the tube that carries urine from the bladder to the outside of the body. The urethra in women is anatomically situated in the pelvic floor, specifically in the perineum, positioned anteriorly and superiorly to the vagina. This procedure is performed to address various medical conditions that may necessitate the removal of the urethra, such as severe trauma, malignancies, or chronic infections. During the operation, a urethral catheter is first inserted to facilitate urine drainage. The surgeon makes an incision around the external urethra and carefully dissects the urethra from the surrounding tissues. Key anatomical structures, including the pubourethral ligament and the urethropelvic ligaments, are identified and transected to free the urethra completely. Once the urethra is entirely detached from the bladder neck to the external meatus, an incision is made above the pubis to access the bladder. The bladder neck is then dissected, and the urethra is excised. To ensure proper urine drainage post-surgery, a cystostomy is created, which involves making an incision in the lower abdomen, excising a section of the rectus fascia, and securing the bladder to the abdominal wall. This comprehensive procedure is critical for patients requiring total urethrectomy and cystostomy, as it addresses significant urinary issues while ensuring that urine can still be effectively drained from the bladder.