Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Bladder Polyps, Benign


Related Terms

  • Benign Polyps with Prostatic-type Epithelium
  • BPPE
  • Urinary Bladder Papilloma
  • Urinary Bladder Polyps

Differential Diagnosis

Specialists

  • Pathologist
  • Urologist

Comorbid Conditions

Factors Influencing Duration

Factors that may influence the length of disability include the development of complications, job requirements, and the possibility of tumor recurrence or metastases into other areas or organs. Heavy physical labor is usually restricted following surgery for bladder polyps until recovery is complete.

Medical Codes

ICD-9-CM:
236.7 - Neoplasm of Uncertain Behavior of Genitourinary Organs; Bladder Polyps
239.4 - Neoplasm of Unspecified Nature, Bladder

Overview

A bladder polyp is a protruding growth from the mucous membrane within the urinary bladder. It is a noncancerous (benign) tumor that originates on the internal bladder wall (epithelial lining) and projects into the bladder cavity. Polyps can be of any size. A polyp with a broad base is called sessile; one with a long, narrow neck is called a pedunculated polyp. The surface of a polyp may be smooth, irregular, or multilobed. Bladder polyps (also called urinary bladder papillomas) do not usually invade the bladder wall itself. However, polyps that are not removed or that recur can transform into cancerous lesions (malignant tumors) in the bladder. For more information on malignant lesions of the bladder, please refer to Bladder Cancer.

Incidence and Prevalence: Urinary bladder polyps are uncommon, accounting for less than 3% of all bladder tumors (Magi-Galluzzi).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Bladder polyps are associated with cigarette smoking, and also tend to occur in individuals who live close to dense industrial areas, suggesting possible environmental or chemical causes.

Bladder polyps occur more frequently in men than women, at a ratio of 1.9:1; the mean age at diagnosis is 57 years (Cheng).

Source: Medical Disability Advisor



Diagnosis

History: Many individuals with bladder polyps are asymptomatic. Occasionally, individuals will report urinary frequency, blood in the urine (hematuria) and, rarely, tenderness on the side (flank) of the body. Individuals with bladder polyps will often report a history of smoking tobacco.

Physical exam: Individuals will appear normal upon physical examination.

Tests: Direct visual examination of the inside of the bladder through a telescoping fiber-optic device (cystoscopy) is used to visualize polyps. A sample of tissue from the polyp (biopsy) may be taken and examined to determine whether it is malignant. Cells from the polyp may also be obtained by flushing the bladder with fluid (bladder washing) and examining the returned fluid. To verify that the polyp is benign, tests for the presence of bladder cancer tumor markers (carcinoembryonic antigen [CEA], polyamines, and fibrin degradation products) may be performed on blood or urine samples. The individual may be asked to collect a midstream urine sample (clean catch) to analyze for blood in the urine (hematuria) and/or the presence of cancerous (malignant) cells.

A radiopaque solution may be injected into the bladder and then x-rayed to evaluate the size and location of the polyp or tumor (intravenous pyelogram or IVP). Computer-aided x-ray analysis (computed tomography or CT scan) may be performed to determine the degree of invasion of the polyp into the bladder wall.

Source: Medical Disability Advisor



Treatment

Bladder polyps are treated by surgical removal. They are usually removed through a lighted, fiber-optic viewing device (cystoscope) that is inserted through the urinary canal (urethra) into the bladder (cystoscopy). In cases where bladder polyps recur or have become deadly (malignant), treatment may necessitate surgically removing all visible tumors (transurethral resection or TUR). Polyps may also be destroyed using electrical current (fulguration).

Source: Medical Disability Advisor



Prognosis

Bladder polyps (urinary bladder papillomas) are most often harmless (benign), so individuals usually have an excellent prognosis following their removal; only 5% to 10% of bladder polyps will progress to cancer ("Bladder Tumors"). Bladder polyps vary greatly in their rate of recurrence, with some types returning infrequently (8.8% recurrence), and some types returning quickly (70% to 75% recurrence) (Cheng; "Bladder Tumors"). Consequently, follow-up bladder ultrasound or cystoscopy with urinalysis is recommended at regular intervals following treatment, usually every 6 months for up to 18 months and then annually.

Source: Medical Disability Advisor



Complications

Complications may include the possibility of a tumor recurring or becoming deadly (malignant), and problems associated with urine flow and kidney function, including inflammation of the urethra (urethritis), bladder (cystitis), or kidney (pyelonephritis). If polyps become malignant, they can spread (metastasize) into the lymph or other organ systems such as the lungs, the circulatory system, bone, and gastrointestinal system.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Time off for surgery and recuperation are usually necessary. Bathroom facilities should be readily available as the individual may have to urinate frequently following surgery. Fatigue may create the need for additional breaks during the recovery period. Otherwise, no work restrictions and accommodations are usually required.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Was blood found in the urine (hematuria)?
  • Does individual smoke tobacco?
  • Was bladder examined with a fiber-optic device (cystoscopy) to visualize the polyps? Was a biopsy taken and examined to determine if malignant? Was a radiopaque solution injected into the bladder then x-rayed?
  • Was a CT scan done to determine the degree of invasion into the bladder wall?
  • Were conditions with similar symptoms ruled out?
  • Was the diagnosis of bladder polyps confirmed?

Regarding treatment:

  • Were polyps removed through cystoscopy, TUR (transurethral resection), or by fulguration? Were any complications associated with the procedure?
  • Has polyp invaded the bladder wall?
  • If the polyp was malignant, has it metastasized into other organ systems?
  • Will treatment now include cystectomy or radical cystectomy?

Regarding prognosis:

  • Have polyps recurred?
  • Would individual benefit from consultation with a specialist (urologist)?
  • Since 5% to 10% of recurring polyps become malignant, is individual being examined on a regular basis?
  • Has individual experienced any complications such as urethritis, cystitis, or pyelonephritis as a result of the bladder polyps? Have complications received prompt, appropriate treatment?
  • If radical cystectomy was necessary to remove all of the bladder and other pelvic organs, were any complications associated with the procedure? Have complications resolved with treatment?
  • Does individual have an underlying condition that may impact recovery?

Source: Medical Disability Advisor



References

Cited

"Bladder Tumours." I.M.M. Department of Urology and Nephrology. 1 Feb. 2005 <http://www.imm.fr/english/dep/uro/urotum.htm#Ancre6>.

Cheng, Liang, et al. "Urothelial Papilloma of the Bladder Clinical and Biologic Implications." Cancer 86 10 (2000): 2098-2101. Wiley InterScience. John Wiley & Sons, Inc. 1 Feb. 2005 <http://www3.interscience.wiley.com/cgi-bin/abstract/75503905/ABSTRACT>.

Magi-Galluzzi, C., and J. I. Epstein. "Urothelial papilloma of the bladder: a review of 34 de novo cases." American Journal of Pathology 28 12 (2004): 1615-1620. PubMed. 27 Feb. 2014 <http://www.ncbi.nlm.nih.gov/pubmed/?term=Benign+Urothelial+Papilloma+of+the+Bladder%3A+A+Review+of+34+Novo+Cases#>.

Source: Medical Disability Advisor






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