CPT® Code 45805

A rectovesical fistula is defined as an abnormal connection between the rectum and the urinary bladder, which can lead to significant clinical complications. This condition may arise as a result of surgical procedures, chronic infections, or inflammation affecting the pelvic structures. The closure of a rectovesical fistula with colostomy, as described by CPT® Code 45805, involves a surgical intervention where the abdomen is accessed to locate the fistula. During the procedure, any adhesions that may exist between the rectum and bladder are carefully lysed to separate these two structures. The surgeon then identifies the opening in the bladder and repairs it using sutures, ensuring that the integrity of the bladder is restored. Following this, the rectum is inspected, and if necessary, it is also closed with sutures. To further reduce the risk of recurrence of the fistula, omentum may be interposed between the bladder and rectum. Additionally, a colostomy is performed to divert stool away from the rectum temporarily, which can be crucial for the healing process. The colostomy is typically created in the sigmoid colon, and various techniques may be employed, including loop colostomy, loop with distal closure, or an end colostomy with a mucous fistula. After the completion of the procedure, drains may be placed in the abdomen as needed, and the abdominal incision is subsequently closed. This comprehensive approach aims to effectively manage the rectovesical fistula while ensuring patient safety and promoting recovery.