CPT® Code 57284

A paravaginal defect repair is a surgical procedure aimed at correcting a specific type of pelvic floor disorder known as a paravaginal defect. This defect occurs when there is a loss of support in the arcus tendineus fascia pelvis (ATFP), which is a critical structure that provides lateral support to the vagina. When the ATFP is compromised, it can lead to the prolapse of the bladder and urethra, resulting in conditions such as cystocele (bladder prolapse) or cystourethrocele (prolapse of both the bladder and urethra). The procedure is performed using an open abdominal approach, which allows the surgeon to access the retropubic space of Retzius while ensuring the protection of surrounding vascular structures. During the surgery, the bladder is mobilized, and the lateral retropubic spaces are exposed to visualize the ATFP. The surgeon identifies the ischial spine and assesses the extent of the defect, which may be unilateral or bilateral. The repair involves suturing the fibromuscular tissue of the vaginal apex to the ATFP or obturator internus fascia, effectively restoring support to the pelvic structures. This procedure is essential for alleviating symptoms associated with pelvic organ prolapse and improving the quality of life for affected individuals.