CPT® Code 57289

The Pereyra procedure, as described by CPT® Code 57289, is a surgical intervention aimed at addressing urinary incontinence, specifically in cases where the patient experiences an inability to control the release of urine. This condition often arises due to weakened pelvic support structures, leading to a displacement of the bladder, which can protrude through the vaginal wall, a condition known as cystocele. The procedure involves a combination of techniques to restore the anatomical integrity of the urethrovesical junction and repair the supporting tissues of the bladder. During the operation, a U-shaped incision is made around the vaginal opening, allowing access to the urethra and bladder junction. The surgeon meticulously opens the space alongside the urethra to facilitate the suturing of fascial tissues to the urethrovesical junction, thereby reinforcing this critical area. Additionally, an abdominal incision is made to facilitate the placement of a Pereyra ligature instrument, which is used to secure the urethrovesical junction to the rectus abdominis muscles. This dual approach not only addresses the incontinence but also corrects the cystocele, thereby enhancing the overall structural support of the pelvic floor. The procedure is comprehensive, combining both the surgical repair of the bladder's support structures and the reinforcement of the urethra, ultimately aiming to restore normal urinary function and improve the patient's quality of life.