CPT® Code 46505

Chemodenervation of the internal anal sphincter is a medical procedure aimed at alleviating the symptoms associated with chronic anal fissures. This condition is characterized by painful tears in the lining of the anal canal, which can lead to significant discomfort and complications if not treated effectively. The procedure involves the administration of a denervation agent, such as botulinum toxin, which is injected into the internal anal sphincter muscle. The primary goal of this intervention is to induce relaxation of the sphincter muscle, thereby reducing the tension at the anal opening. This reduction in muscle tension facilitates the healing process of the fissure by allowing for improved blood flow and decreased pain during bowel movements. The physician carefully identifies the location of the fissure and the specific area of the internal anal sphincter that requires treatment. The denervation agent is then injected in divided doses around the targeted area, ensuring that the muscle is effectively treated. The onset of action for the denervation agent is typically rapid, with paralysis of the muscle occurring within a few hours, leading to a significant reduction in symptoms for the patient.