CPT® Code 57287

The procedure described by CPT® Code 57287 involves the removal or revision of a previously placed sling that is used to treat stress incontinence. Stress incontinence is a condition characterized by involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercise. The sling, which can be made from either fascial tissue or synthetic materials, is designed to support the urethra and prevent this leakage. Over time, complications may arise that necessitate the removal or revision of the sling. Common reasons for removal include urethral erosion, where the sling causes damage to the urethra, or vaginal extrusion, where the sling protrudes through the vaginal wall. Revision of the sling may be indicated in cases of recurrent stress incontinence, where the initial treatment has not provided the desired results, or if there is vaginal extrusion of the sling. The procedure typically involves a vaginal approach, where a Foley catheter is inserted to facilitate access to the bladder. The surgeon carefully dissects the sling from the surrounding tissue, ensuring that any permanent suture material is also removed. If urethral erosion is present, the procedure includes repairing the urethral defect with sutures and may involve the use of a labial fat graft to reinforce the repair. In cases of vaginal extrusion, the sling may be revised by trimming the mesh and excising any granulation tissue, followed by a two-layer repair of the vaginal defect. If the revision is due to recurrent stress incontinence, the sling may be shortened and reattached to the pelvic fascia or abdominal wall, ensuring proper support for the urethra.