CPT® Code 53500

The procedure described by CPT® Code 53500 refers to urethrolysis, which is a surgical intervention aimed at relieving postoperative obstruction or scarring of the urethra. This specific procedure is performed transvaginally and is classified as secondary, indicating that it is typically conducted after a previous surgical intervention has resulted in complications such as scarring or obstruction. The process begins with cystourethroscopy, a diagnostic technique that allows the surgeon to visualize the urethra and bladder. During this step, a cystourethroscope is inserted through the urethral opening and advanced toward the bladder to identify any areas of concern, including tissue erosion, scarring, stenosis (narrowing of the urethra), obstruction, or the formation of fistulas (abnormal connections between the urethra and other structures). Following the cystourethroscopy, the surgeon makes a midline or U-shaped incision in the anterior vaginal wall to access the urethra. The dissection continues along the periurethral fascia, which is the connective tissue surrounding the urethra, allowing for the exposure of the retropubic space. This space is crucial for accessing the urethra and bladder to perform the necessary lysis of adhesions and scar tissue. The procedure concludes with the closure of the incision in layers, and a catheter may be placed transurethrally to facilitate urinary drainage postoperatively. This comprehensive approach ensures that any obstructions are effectively addressed, restoring normal function to the urinary tract.