**§4.115a Ratings of the genitourinary system---dysfunctions.**

Diseases of the genitourinary system generally result in disabilities
related to renal or voiding dysfunctions, infections, or a combination
of these. The following section provides descriptions of various levels
of disability in each of these symptom areas. Where diagnostic codes
refer the decisionmaker to these specific areas of dysfunction, only the
predominant area of dysfunction shall be considered for rating purposes.
Since the areas of dysfunction described below do not cover all symptoms
resulting from genitourinary diseases, specific diagnoses may include a
description of symptoms assigned to that diagnosis.

Rating

**Renal dysfunction**:

Requiring regular dialysis, or precluding more than sedentary activity

from one of the following: persistent edema and albuminuria;

or, BUN more than 80mg%; or, creatinine more than 8mg%; or,

markedly decreased function of kidney or other organ systems,

especially cardiovascular 100

Persistent edema and albuminuria with BUN 40 to 80mg%; or,

creatinine 4 to 8mg%; or, generalized poor health characterized by

lethargy, weakness, anorexia, weight loss, or limitation of exertion 80

Constant albuminuria with some edema; or, definite decrease in kidney

function; or, hypertension at least 40 percent disabling under

diagnostic code 7101 60

Albumin constant or recurring with hyaline and granular casts or red

blood cells; or, transient or slight edema or hypertension at least

10 percent disabling under diagnostic code 7101 30

Albumin and casts with history of acute nephritis; or, hypertension

non-compensable under diagnostic code 7101 0

**Voiding dysfunction**:

Rate particular condition as urine leakage, frequency, or obstructed
voiding.

Continual Urine Leakage, Post Surgical Urinary Diversion,

Urinary Incontinence, or Stress Incontinence:

Requiring the use of an appliance or the wearing of absorbent

materials which must be changed more than 4 times per day 60

Requiring the wearing of absorbent materials which must be

changed 2 to 4 times per day 40

Requiring the wearing of absorbent materials which must be

changed less than 2 times per day 20

**Urinary frequency**:

Daytime voiding interval less than one hour, or; awakening to

void five or more times per night 40

Daytime voiding interval between one and two hours, or;

awakening to void three to four times per night 20

Daytime voiding interval between two and three hours, or;

awakening to void two times per night 10

**Obstructed voiding**:

Urinary retention requiring intermittent or continuous catheterization
30

Marked obstructive symptomatology (hesitancy, slow or weak stream,
decreased force of stream) with any one or combination of the following:

1\. Post void residuals greater than 150 cc

2\. Uroflowmetry; markedly diminished peak flow rate

(less than 10 cc/sec)

3\. Recurrent urinary tract infections secondary to obstruction

4\. Stricture disease requiring periodic dilatation every 2 to 3 months
10

Obstructive symptomatology with or without stricture disease requiring

dilatation 1 to 2 times per year 0

**Urninary tract infection**:

Poor renal function: Rate as renal dysfunction.

Recurrent symptomatic infection requiring drainage/frequent

hospitalization (greater than two times/year), and/or requiring

continuous intensive management 30

Long-term drug therapy, 1-2 hospitalizations per year and/or

requiring intermittent intensive management 10

\[59 FR 2527, Jan. 18, 1994; 59 FR 10676, Mar. 7, 1994\]

**Supplement *Highlights* reference**: 7(1)

*Next Section is §4.115b*