CPT® Code 46746

The CPT® Code 46746 refers to the surgical procedure known as the repair of a cloacal anomaly through anorectovaginoplasty and urethroplasty, utilizing a combined abdominal and sacroperineal approach. Cloacal anomalies are congenital defects that occur exclusively in females, characterized by the abnormal fusion of the rectum, vagina, and urethra into a single common channel. This condition necessitates surgical intervention to separate these structures and create functional openings for normal bodily functions. The specific surgical approach and techniques employed during the repair depend on the precise nature of the cloacal anomaly, particularly the location where the rectum, vagina, and urethra converge. In the case of a high cloacal anomaly, as indicated by CPT® Code 46746, the procedure begins with an incision in the lower abdomen, which is extended down to the bladder and rectum. This allows for the mobilization and repair of the rectum, as well as the separation of the vagina and urinary tract to achieve the necessary length for proper positioning at the perineum. The surgical team carefully dissects the urogenital structures to facilitate this separation. Once the vagina and urethra are adequately mobilized, vaginoplasty and urethroplasty are performed to establish functional openings in the perineum, ensuring that the patient can achieve normal urinary and reproductive functions post-surgery. This complex procedure requires a high level of surgical skill and precision to ensure successful outcomes and minimize complications.