# periurethral Cyst removal



## karey (Feb 26, 2015)

[FONT=COURIER,sans-serif]The provder wants me to use 53400 which I think is way off base. I found something online that suggested using 53260, 53265 or 57135. The op note is below and the path came back as Benign mucinous periurethral cyst.[/FONT]
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[FONT=COURIER,sans-serif]FINDINGS: A small 1 x 2 cm periurethral cyst inferior to the urethral [/FONT][FONT=COURIER,sans-serif]meatus, 1 cm in from the introitus.[/FONT]
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[FONT=COURIER,sans-serif]DESCRIPTION OF PROCEDURE: The patient was taken to the operating room [/FONT][FONT=COURIER,sans-serif]where general endotracheal anesthesia was established. She was prepped [/FONT][FONT=COURIER,sans-serif]and draped in the usual sterile fashion, placed in the dorsal supine [/FONT][FONT=COURIER,sans-serif]position with her legs in candy-cane stirrups. A Foley catheter was [/FONT][FONT=COURIER,sans-serif]placed sterilely and the bladder was drained. An Allis clamp was placed [/FONT][FONT=COURIER,sans-serif]around this soft compressible but demarcated submucosal cyst. The[/FONT]
[FONT=COURIER,sans-serif]mucosa was then injected with 1% lidocaine with epinephrine around the [/FONT][FONT=COURIER,sans-serif]margins of the cyst and a 15 blade scalpel was used to make a [/FONT][FONT=COURIER,sans-serif]curvilinear incision inferior to the cyst in the vaginal mucosa. The [/FONT][FONT=COURIER,sans-serif]tenotomy scissors were then used to sharply dissect the mucosa off of [/FONT][FONT=COURIER,sans-serif]the underlying periadventitial tissue circumferentially around the cyst.[/FONT]
[FONT=COURIER,sans-serif]The muscularis adherent to the posterior side of the cyst wall was then [/FONT][FONT=COURIER,sans-serif]taken down sharply until the cyst was isolated in its entirety and [/FONT][FONT=COURIER,sans-serif]removed from the field. The dissection bed was relatively hemostatic. [/FONT][FONT=COURIER,sans-serif]A small amount of cautery was used, and then 2-0 Polysorb sutures were [/FONT][FONT=COURIER,sans-serif]used to imbricate the bed to close the dead space and obtained [/FONT][FONT=COURIER,sans-serif]hemostasis. The mucosa was then reapproximated using interrupted 2-0 [/FONT][FONT=COURIER,sans-serif]Polysorb sutures with excellent hemostasis noted. The Foley catheter [/FONT][FONT=COURIER,sans-serif]was removed and the procedure was terminated.[/FONT]​


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