CPT® Code 57285

A paravaginal defect repair is a surgical procedure performed through the vaginal approach to correct a paravaginal defect, which is characterized by the loss of support of the arcus tendineus fascia pelvis (ATFP). This loss of support can lead to the prolapse of the bladder and urethra, resulting in conditions such as cystocele or cystourethrocele. During the procedure, the surgeon makes an incision in the anterior vaginal wall to access the retropubic space, also known as the space of Retzius. This access allows for the dissection of the bladder away from the vaginal epithelium, enabling the surgeon to expose the ATFP. The repair involves placing sutures at the site of the defect, which can be unilateral or bilateral, and securing them through the pubocervical fascia and the internal obturator muscle. The sutures are then tied to obliterate the defect, followed by the repair of the vaginal wall incisions. If a cystocele repair is necessary, it is included as part of this procedure. This surgical intervention aims to restore the normal anatomical position of the bladder and urethra, thereby alleviating symptoms associated with pelvic organ prolapse.