CPT® Code 58267

Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control

The CPT® Code 58267 refers to a surgical procedure known as a vaginal hysterectomy, specifically for a uterus weighing 250 grams or less. This procedure is performed in conjunction with a colpo-urethrocystopexy, which is a surgical technique aimed at correcting pelvic organ prolapse and providing support to the bladder and urethra. The colpo-urethrocystopexy can be performed using the Marshall-Marchetti-Krantz or Pereyra techniques, with or without the assistance of endoscopic control. During the procedure, the surgeon utilizes tenacula to grasp the cervix, allowing for a clear incision of the vaginal mucosa around the cervix. The subsequent steps involve meticulous dissection to separate the bladder from the uterus, exposing critical anatomical structures such as the peritoneal vesicouterine fold and the cul-de-sac. The procedure requires careful clamping, division, and ligation of various ligaments, including the uterosacral and cardinal ligaments, to facilitate the removal of the uterus. Following the hysterectomy, the colpo-urethrocystopexy is performed to ensure proper suspension of the vaginal wall and urethra, which is essential for preventing future prolapse. The surgical site is thoroughly inspected for bleeding, and the peritoneum is closed, with the vaginal cuff left open to allow for drainage. This comprehensive approach addresses both the removal of the uterus and the support of the pelvic structures, making it a significant procedure in gynecological surgery.