CPT® Code 57291

The construction of an artificial vagina is a surgical procedure aimed at addressing the congenital absence of the vagina, a condition that can significantly impact an individual's quality of life. This procedure is particularly relevant for individuals who may have been born with a condition known as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, where the vagina and sometimes the uterus are underdeveloped or absent. The specific CPT® Code 57291 refers to the construction of an artificial vagina performed without the use of a graft. This means that the procedure focuses solely on the surgical creation of the vaginal canal using the body's own tissues, rather than incorporating additional tissue from another site. The surgical technique involves making an H-shaped incision between the urethra and rectum, followed by the careful dissection to form a cavity that can serve as the vaginal canal. The extent of the cavity's creation may vary based on the presence of a functioning uterus; if a uterus is present, the cavity is extended to the lowest point of the uterine cavity, while in its absence, the cavity is created up to the peritoneum. The procedure also includes measures to control bleeding, such as electrocoagulation, and the placement of a vaginal stent to maintain the newly formed canal's structure during the healing process. This procedure is critical for enabling sexual function and improving the overall well-being of individuals affected by this congenital condition.