CPT® Code 46744

The CPT® Code 46744 refers to the surgical procedure known as the repair of a cloacal anomaly through anorectovaginoplasty and urethroplasty, utilizing a sacroperineal approach. Cloacal anomalies are congenital defects that occur exclusively in females, characterized by the abnormal merging of the rectum, vagina, and urethra into a single common channel. This condition necessitates surgical intervention to create separate functional openings for the rectum, vagina, and urethra. The specific surgical approach and repair technique employed depend on the precise nature of the cloacal anomaly and the anatomical configuration of the merging structures. In the case of a low cloacal anomaly, the sacroperineal approach is utilized, which involves making an incision in the posterior aspect of the perineum. This allows for dissection to the presacral space, where the rectal pouch can be identified and mobilized. The procedure aims to restore normal anatomy and function by carefully separating and reconstructing the affected structures, ensuring that the patient can achieve proper bowel and urinary function postoperatively.