The prostate gland is a structure that surrounds the neck of the bladder and urethra with ducts that enter into the urethra. This diagnostic code involves conditions of the prostate gland including: any nonmalignant infection; trauma; benign prostatic hypertrophy (BPH); or a surgical procedure in which the reproductive or bladder function is impaired.

The incidence of prostate gland enlargement is most often related to age. Prevalence is estimated at 20% of the male population 41 to 50 years of age and 80% of men over 80 years of age. The cause is not completely understood. Other prostatic disorders may arise from an infectious process, surgery, or trauma.

The following symptoms may be included with prostatic disorders: frequent urination; difficulty with urination; decreased strength and force of the urine stream; nocturia; and dribbling at the end of urination. In addition, there may be fever; urgency to urinate; pain in the lower back and the area between the rectum and the testicles; pain or burning while urinating; painful ejaculation; and hematuria.

Tests done to investigate prostatic disorders may include, but are not limited to the following: urinalysis; intravenous urography; uroflowmetry; cystourethrography; and determination of the prostate-specific antigen (PSA) values. In addition, tests to evaluate creatinine levels, blood urea nitrogen (BUN), and phosphate and calcium levels may be done to determine if metastasis to the bone has occurred. Other diagnostic measures may include: prostatic biopsy; ultrasound; magnetic resonance imaging (MRI); and computed tomography (CT) scan.

Initially, medical treatment for BPH may be recommended. Medications can be given aimed at shrinking the prostate gland. Removal of obstructing tissue in the gland, or complete removal of the gland may also be performed. Surgery may be performed through an incision in the perineum, bladder, or the urethra. However, the most common surgical procedure is the transurethral resection of the prostate (TURP) which requires no incision. A transurethral incision of the prostate (TUIP) may aid some younger men with signs and symptoms of BPH when smaller glands are involved. Furthermore, antibiotics are used to treat disorders due to an infectious process, and medications for discomfort may also be given.

Untreated infections of the prostate can lead to abscesses or complete retention of urine. Incontinence and impotence are also possible results. When impotence results, psychological counseling may be required. Repeating surgery is indicated in less than 10% of cases. The associated risk of death may be higher among patients undergoing surgery via the urethra (transurethral) as opposed to an open prostatectomy.

• The new criteria for the Genitourinary Disease and Conditions body system became effective November 14, 2021.  Review both current and historic criteria prior to any reduction for disabilities established before that date.  38 CFR 3.951(a)

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350 (i)(1) – Total plus 60% and – Special Monthly Compensation (SMC).

• A report of the Institute of Medicine of the National Academy of Sciences has identified some long-term health effects, listed in the table embedded within 38 CFR 3.317(d), that potentially are associated with the infectious diseases listed in 38 CFR 3.317(c)(2). These health effects and diseases are listed alphabetically and are not categorized by the level of association stated in the National Academy of Sciences report. If a veteran who has or had an infectious disease identified in column A also has a condition identified in column B as potentially related to that infectious disease, VA must determine, based on the evidence in each case, whether the column B condition was caused by the infectious disease for purposes of paying disability compensation. This does not preclude a finding that other manifestations of disability or secondary conditions were caused by an infectious disease. See 38 CFR 3.317(d) - Long-term health effects potentially associated with infectious diseases.

• If a Veteran presumed service connected for one of the diseases listed in 38 CFR 3.317(c)(2) is diagnosed with one of the diseases listed in column “B” in the table embedded within 38 CFR 3.317(d) within the time period specified for the disease in the same table, if a time period is specified or, otherwise, at any time, VA will request a medical opinion as to whether it is at least as likely as not that the condition was caused by the veteran having had the associated disease in column “A” in that same table. See 38 CFR 3.317(d) - Long-term health effects potentially associated with infectious diseases.

• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.