Urinary and prostate: voiding, infection and the exam

How VA rates urinary and prostate conditions

38 CFR 4.115a, 4.115b

The genitourinary schedule groups problems into three areas: renal dysfunction (covered on the kidney conditions page), voiding dysfunction and urinary tract infection. Many bladder, urethra and prostate codes just say to rate as voiding dysfunction or as infection, whichever is predominant.

Where a code refers VA to one of these areas, only the predominant area of dysfunction is rated. Distinct disabilities may be rated separately if their symptoms do not overlap (38 CFR 4.14).

Urine leakage and incontinence

38 CFR 4.115a, voiding dysfunction

For continual urine leakage, post-surgical urinary diversion, urinary incontinence or stress incontinence:

• 60%: requires an appliance, or absorbent materials changed more than 4 times a day.
• 40%: absorbent materials changed 2 to 4 times a day.
• 20%: absorbent materials changed less than 2 times a day.

Urinary frequency and getting up at night

38 CFR 4.115a, voiding dysfunction

• 40%: daytime voiding interval less than one hour, or waking to void five or more times a night.
• 20%: daytime interval one to two hours, or waking to void three to four times a night.
• 10%: daytime interval two to three hours, or waking to void two times a night.

Either the daytime interval or the night waking can support the level.

Obstructed voiding

38 CFR 4.115a, voiding dysfunction

• 30%: urinary retention requiring intermittent or continuous catheterization.
• 10%: marked obstructive symptoms (hesitancy, slow or weak stream, decreased force of stream) with one or more of: post-void residual over 150 cc; uroflowmetry with a markedly diminished peak flow rate (under 10 cc/sec); recurrent urinary tract infections secondary to obstruction; or stricture disease requiring dilatation every 2 to 3 months.
• 0%: obstructive symptoms, with or without stricture disease requiring dilatation one to two times a year.

Urinary tract infection

38 CFR 4.115a

• 30%: recurrent symptomatic infection requiring drainage by stent or nephrostomy tube, or more than 2 hospitalizations a year, or continuous intensive management.
• 10%: recurrent symptomatic infection requiring 1 to 2 hospitalizations a year, or suppressive drug therapy lasting six months or longer.
• 0%: recurrent symptomatic infection not requiring hospitalization, but requiring suppressive drug therapy for less than six months.

With poor renal function, rate as renal dysfunction instead.

Codes that send VA to voiding dysfunction

38 CFR 4.115b, DC 7512 to 7545

• Chronic cystitis (7512), including interstitial cystitis, infectious or not: rate as voiding dysfunction.
• Bladder stone with symptoms interfering with function (7515), bladder injury (7517), urethral stricture (7518): rate as voiding dysfunction.
• Bladder fistula (7516): voiding dysfunction or infection, whichever is predominant. After a suprapubic cystotomy, 100%.
• Urethral fistula (7519): voiding dysfunction. Multiple urethroperineal fistulae: 100%.
• Neurogenic bladder (7542) and bladder diverticulum (7545): voiding dysfunction or infection, whichever is predominant.

Prostate conditions and prostate cancer

38 CFR 4.115b, DC 7525, 7527, 7528

• Prostate injury, infection, enlargement, post-surgical residuals, bladder outlet obstruction (7527): voiding dysfunction or urinary tract infection, whichever is predominant.
• Chronic prostatitis, urethritis, epididymitis or orchitis (7525): rated as urinary tract infection.
• Malignant genitourinary cancer, including prostate cancer (7528): 100%. After surgery, radiation, chemotherapy or other treatment ends, the 100% continues with a mandatory VA exam six months later. If there is no local recurrence or spread, it is rated on residuals as voiding or renal dysfunction, whichever is predominant.

Prostate and bladder cancer appear on VA presumptive lists shown on presumptive conditions by era.

Erectile dysfunction, penis and testicle

38 CFR 4.115b, DC 7520 to 7524, 7543

• Erectile dysfunction, with or without penile deformity (7522): 0%. That is the only level. A penile disease or injury resulting in scarring or deformity is rated under this code.
• Penis, half or more removed (7520): 30%. Glans removed (7521): 20%.
• Testis, complete atrophy (7523): both 20%, one 0%.
• Testis removal (7524): both 30%, one 0%. If one testis is removed from a service-incurred injury or disease and the other is absent or nonfunctioning for reasons unrelated to service, 30% is assigned. An undescended or congenitally undeveloped testis is not a ratable disability.
• Varicocele or hydrocele (7543): 0%.

The schedule marks codes 7520 through 7524, and 7543, for review for special monthly compensation for loss or loss of use of a creative organ. See diabetes, thyroid and adrenal ratings and special monthly compensation.

What VA’s urinary and male reproductive exam forms cover

VA Urinary Tract Conditions DBQ (2024-07-16); Male Reproductive Organ Conditions DBQ (2025-09-26)

Urinary Tract Conditions form:

• Voiding dysfunction: leakage and how often absorbent material is changed, whether an appliance is needed, daytime intervals and nighttime awakenings, hesitancy or weak stream, uroflowmetry, post-void residual, catheterization, stricture dilatation.
• Stones, catheter drainage, and infection: suppressive drug therapy, stent or nephrostomy drainage, intensive management, hospitalizations per year.
• Other bladder conditions: fistula, diverticulum, suprapubic cystotomy, neurogenic bladder, injury. Tumors, testing and functional impact on work.

Male Reproductive Organ Conditions form:

• A diagnosis checklist: erectile dysfunction, testis atrophy or removal, epididymitis, orchitis, prostatitis, urethritis, varicocele or hydrocele, prostate conditions, and neoplasms including prostate cancer.
• Medical history and continuous medication, voiding dysfunction, erectile dysfunction, retrograde ejaculation, and infections.
• A physical exam of the penis, testes, epididymis and prostate.
• Tumor treatment (surgery, radiation, chemotherapy, brachytherapy, androgen deprivation therapy) and residuals, biopsy results, and functional impact.

See Preparing for Your C&P Exam.

How these ratings add up

38 CFR 4.115a, 4.14, 4.25

Only the predominant area is rated where a code sends VA to voiding dysfunction or infection. Distinct disabilities that do not overlap can be rated separately. Separate ratings combine, not add. See Why 50% + 50% Is Not 100%. If bladder trouble comes from a back or nerve condition, the spine rules require it to be evaluated separately. See lumbar spine secondaries. If a condition has worsened, see When To Ask VA For A Rating Increase.

What I could not verify

• The rating levels come from the eCFR text of 38 CFR 4.115a and 4.115b (current as of October 16, 2026). eCFR is unofficial, and the official text wins over me.
• I checked both exam forms through a text reader of VA’s PDFs, not line by line. The forms themselves are the authority.
• This page covers the urinary and male reproductive parts of the schedule. Conditions of the female reproductive organs and breast are rated in a different section (38 CFR 4.116) and are not covered here.
• I did not research medical causes of any of these conditions, or which medicines or other conditions lead to them.
• I did not check whether VA treats nighttime urination counts or pad changes in any particular way beyond what the rule says.