CPT® Code 46742

Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches

An imperforate anus is a congenital condition characterized by the absence of a proper anal opening, which may manifest as a small fistulous tract instead. The term "high imperforate anus" is considered outdated; however, it generally refers to a malformation located above the levator ani muscles. This condition falls under the broader category of anorectal malformations, which are now classified based on specific anatomical features. The surgical procedure associated with CPT® Code 46742 involves a complex repair of a high imperforate anus that includes the presence of a rectourethral or rectovaginal fistula. This procedure employs both transabdominal and sacroperineal approaches to effectively address the malformation. The surgical technique requires careful dissection and mobilization of the rectal pouch, ensuring complete separation from any attachments to the genitourinary tract. The identification and excision of the fistulous tract are critical steps in the procedure, followed by the reconstruction of the anal opening. This intricate operation aims to restore normal anatomy and function, thereby improving the patient's quality of life.