Genitourinary Overview

Conditions considered in this diagnostic category include pathological entities pertaining to the renal and urologic tract which are common to both sexes, and conditions affecting only the male reproductive system. Conditions of the female reproductive system are included under the separate diagnostic category entitled, Gynecological Conditions and Disorders of the Breast.

Important functions of the kidney and urinary system are to remove excess fluid and waste materials, and to retain substances ultimately related to regulating acid-base balance, fluid and electrolyte balance, and, indirectly, all body fluids. The system includes: two organs shaped like beans, with each one positioned at the back of the cavity of the abdomen on each side of the spinal column (kidneys); two muscular tubes, each originating in a kidney, that serve as ducts to carry urine from each kidney to the bladder (ureter); a muscular reservoir located in the anterior portion of the lower pelvis cavity that stores urine (the bladder); and a tube for discharge of urine that extends from the bladder to the outside (urethra). In females, the urethral opening (meatus) lies between the vagina and the clitoris (anterior to the vaginal opening). In males, the urethra passes through the prostate gland and penis, with the opening (meatus) at the end of the penis. In males, semen and urine use the urethra as a passageway.

The principal organs of the urinary system are the kidneys. The basic structural units of the kidneys are the nephrons which carry out the two main functions of the urinary system; mechanical filtration of fluid and selective reabsorption and secretion of ions. The nephron consists of glomeruli (tufts of small blood vessels) surrounded by Bowman's capsule, a tubular apparatus, and a collecting duct. Blood enters the kidney through the renal artery and then passes through the nephrons. The collecting tubules unite to form ducts that empty urine into extensions of the pelvis of the kidney (calyces). Following entrance into the ureters, the urine is transported to the bladder. Normal functioning involves voluntary control of expulsion of urine from the bladder through the urethra, stimulated by neural effects on the bladder.

There is an overlap particularly involving the urinary and reproductive systems of men. The organs of the male reproductive system consist of external and internal structures. External structures include the penis and the scrotum, and internal structures include the prostate gland, the seminal vesicles, and several ducts. The penis, composed of erectile tissue and skin, is the male sexual organ. The scrotum, a pouch-like structure consisting of two halves, contains the testicles and part of the spermatic cord. Sperm cells are produced in the testicles, and the male hormone (testosterone) is secreted by the testicles. The prostate gland surrounds the neck of the bladder and the urethra, and has openings into the urethra. The gland secretes a fluid that forms a part of the discharge of semen. The seminal vesicles lie behind the bladder close to the prostate gland and secrete a fluid that forms a part of the semen. The seminal ducts function to convey sperm.

General Considerations for Rating

  • Nephritis.

    Albuminuria alone is not nephritis, nor will the presence of transient albumin and casts following acute febrile illness be taken as nephritis. The glomerular type of nephritis is usually preceded by or associated with severe infectious disease; the onset is sudden, and the course marked by red blood cells, salt retention, and edema; it may clear up entirely or progress to a chronic condition. The nephrosclerotic type, originating in hypertension or arteriosclerosis, develops slowly, with minimum laboratory findings, and is associated with natural progress. Separate ratings are not to be assigned for disability from disease of the heart and any form of nephritis, on account of the close interrelationships of cardiovascular disabilities. If, however, absence of a kidney is the sole renal disability, even if removal was required because of nephritis, the absent kidney and any hypertension or heart disease will be separately rated. Also, in the event that chronic renal disease has progressed to the point where regular dialysis is required, any coexisting hypertension or heart disease will be separately rated. 38 CFR §4.115 [Schedule of ratings-genitourinary system]

  • Ratings of the genitourinary system—diagnoses.

    When evaluating any claim involving loss or loss of use of one or more creative organs, refer to §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. 38 CFR §4.115b [Schedule of ratings-genitourinary system]

Problematic Issues

  • Renal Function Tests

Genitourinary (DCs 7500-7524)

Diagnostic Code Name VA Exam Acronym
7500 Kidney, removal of one Genitourinary ---
7501 Kidney, abscess of Genitourinary ---
7502 Nephritis, chronic Genitourinary ---
7504 Pyelonephritis, chronic Genitourinary CHPN
7505 Kidney, tuberculosis of Genitourinary ---
7507 Nephrosclerosis, arteriolar Genitourinary NS, NSCL
7508 Nephrolithiasis Genitourinary ---
7509 Hydronephrosis Genitourinary HN
7510 Ureterolithiasis Genitourinary ---
7511 Ureter, stricture of Genitourinary ---
7512 Cystitis, chronic, includes interstitial and all etiologies, infectious and non-infectious Genitourinary CYIS
7515 Bladder, calculus in, with symptoms interfering with function Genitourinary ---
7516 Bladder, fistula of Genitourinary ---
7517 Bladder, injury of Genitourinary ---
7518 Urethra, stricture of Genitourinary ---
7519 Urethra, fistula of Genitourinary ---
7520 Penis, removal of half or more Genitourinary ---
7521 Penis, removal of glans Genitourinary ---
7522 Penis, deformity, with loss of erectile power Genitourinary ---
7523 Testis, atrophy complete Genitourinary ---
7524 Testis, removal Genitourinary ---

Genitourinary (DCs 7525-7545)

Diagnostic Code Name VA Exam Acronym
7525 Epidiodymo-orchitis, chronic only Genitourinary ---
7527 Prostate gland injuries, infections, hypertrophy, post-operative residuals Genitourinary ---
7528 Malignant neoplasms of the genitourinary system Genitourinary ---
7529 Benign neoplasms of the genitourinary system Genitourinary ---
7530 Chronic renal disease requiring regular dialysis Genitourinary ---
7531 Kidney transplant Genitourinary KT, KITR
7532 Renal tubular disorders Genitourinary ---
7533 Cystic diseases of the kidneys Genitourinary PCK
7534 Atherosclerotic renal disease (renal artery stenosis or atheroembolic renal disease) Genitourinary ---
7535 Toxic nephropathy Genitourinary ---
7536 Glomerulonephritis Genitourinary ---
7537 Interstitial nephritis Genitourinary IN, ITN
7538 Papillary necrosis Genitourinary PN
7539 Renal amyloid disease Genitourinary ---
7540 Disseminated intravascular coagulation with renal cortical necrosis Genitourinary DIC with RCN
7541 Renal involvement in diabetes mellitus, sickle cell anemia, systemic lupus erythematosus, vasculitis, or other systemic disease processes Genitourinary ---
7542 Neurogenic bladder Genitourinary ---
7543 Varicocele/Hydrocele ---
7544 Renal disease caused by viral infection such as human immunodeficiency virus (HIV), Hepatitis B, and Hepatitis C ---
7545 Bladder, diverticulum of ---

Analogous

Diagnostic Code Name
7599-7508 Nephrocalcinosis
7599-7518 Gonorrhea
7599-7522 Impotency
7599-7522 Peyronie's disease
7599-7523 Hydrocele
7599-7525 Epididymitis, bilateral
7599-7525 Orchialgia

Historical

Old Diagnostic Code Name New Diagnostic Code
7503 Pyelitis Deleted
7505 Tuberculosis of Kidney Same Number - Rating Criteria Changed
7509 Hydronephrosis Same Number - Rating Criteria Changed
7513 Cystitis, interstitial (Hunner), submucous or elusive ulcer Deleted
7524 Removal of Testis Same Number - Rating Criteria Changed
7525 Epididymal Infection Same Number - Rating Criteria Changed
7526 Prostate gland, resection or removal Deleted