CPT® Code 58152

Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch)

The CPT® Code 58152 refers to a surgical procedure known as a total abdominal hysterectomy, which involves the complete removal of the uterus, including both the corpus and cervix. This procedure may also include the optional removal of the fallopian tubes and/or ovaries. The surgery is performed through an incision made in the abdomen, allowing the surgeon to access the anterior surface of the uterus. During the operation, the peritoneum at the cervicovesical fold is incised, and blunt dissection is utilized to expose the broad ligament, round ligament, and fallopian tubes. If the decision is made to remove the fallopian tubes and/or ovaries, the surgeon makes an incision in the broad ligament to visualize and ligate the ovarian vessels. The procedure continues with the careful dissection of the fallopian tubes and ovaries from surrounding tissues, followed by the clamping and division of the round ligaments and blood vessels. The cervix is palpated to ascertain the position of the bladder, which is then dissected off the uterus down to the vaginal wall. The posterior aspect of the uterus is inspected to ensure there are no adhesions to the rectum. The uterine vessels are clamped, divided, and ligated, and the posterior cervical peritoneum is incised, extending around the cervix. The vaginal wall is then incised, allowing for the separation of the cervix from the vagina. The uterus and cervix, along with any removed tubes and ovaries, are extracted, and the vaginal opening is subsequently closed. The surgical site is inspected for bleeding, which is controlled before the abdominal incision is closed. In addition to the hysterectomy, this procedure includes a colpo-urethrocystopexy, which is a surgical technique used to suspend the prolapsed vaginal wall and urethra. This is achieved by placing sutures through the paravaginal fascia at the urethrovesical junction, which are then anchored to the Cooper's ligament, pelvic fascia, or pubic bone to provide necessary support to the bladder and urethra. If further suspension is needed, additional sutures may be placed along the base of the bladder to ensure proper support and stability.