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.

Urethritis


Related Terms

  • Inflammation of Urethra

Differential Diagnosis

Specialists

  • Gynecologist
  • Urologist

Comorbid Conditions

  • Disorders requiring catheterization
  • HIV/AIDS

Factors Influencing Duration

The length of disability may be influenced by the severity of the symptoms, the underlying cause of the condition, and the response to treatment. Disability may be prolonged if the infective agent does not respond to antibiotic therapy.

Medical Codes

ICD-9-CM:
099.40 - Venereal Diseases, Other; Urethritis, Other Nongonococcal, Unspecified
099.41 - Venereal Diseases, Other; Nongonococcal Urethritis Due to Chlamydia Trachomatis
099.49 - Venereal Diseases, Other; Nongonococcal Urethritis Due to Other Specified Organism
597.80 - Other Urethritis, Not Sexually Transmitted, and Urethral Syndrome, Urethritis, Unspecified
597.89 - Other Urethritis; Adenitis, Skenes Glands; Cowperitis; Meatitis, Urethral; Ulcer, Urethra (meatus); Verumontanitis

Overview

© Reed Group
Urethritis is an inflammation of the urethra, the tube that carries urine from the bladder to the outside of the body. Urethritis is usually due to an infection and may be caused by a variety of organisms, including bacteria, virus, protozoa, and yeasts. It may be caused by the same organisms that cause bladder or kidney infections (e.g., Escherichia coli or Klebsiella), herpes (herpes simplex virus [HSV]), and some sexually transmitted infections (STIs, e.g., Chlamydia, Neisseria gonorrhoeae, Urea plasma urealyticum, and Trichomonas vaginalis infections). Noninfectious urethritis is often the result of medical catheterization. Urethritis may also develop because of a chemical sensitivity that results in irritation, such as from spermatocides in condoms, contraceptive jelly, cream, or foam. Penetrating trauma to the urethra may also cause urethritis.

Incidence and Prevalence: In the US, incidence of urethritis is 4 million cases each year, and incidence of gonococcal urethritis is over 700,000 cases each year; internationally, the incidence of gonococcal urethritis is 62 million per year, and incidence of non-gonococcal urethritis is 89 million each year (Terris). Urethritis may be associated with other infectious conditions, including acute cystitis, orchitis, prostatitis, epididymitis, and proctitis. Noninfectious urethritis occurs in up to 20% of individuals in the US who have been intermittently catheterized as a result of other medical conditions; it is also more common among those using latex catheters as opposed to silicone (Terris).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Infectious urethritis is considered the most common sexually transmitted syndrome among men in the US. Up to 50% of cases in women may be asymptomatic and go unrecognized; therefore, although reported incidence of urethritis is equal in males and females, data may be skewed (Terris). There is an increased risk among sexually active individuals, with the highest incidence occurring in those between the ages of 20 to 24 years. Unprotected sexual intercourse, multiple sexual partners, and high-risk sexual behaviors are the main risk factors.

Source: Medical Disability Advisor



Diagnosis

History: Onset tends to be gradual. Individuals with urethritis complain of a painful, burning sensation with urination (dysuria). The symptoms are usually mild, and in approximately 25% of cases of nongonococcal urethritis there are no symptoms at all. In these cases, the condition is usually discovered after a partner is diagnosed with an STI. In severe cases, the pain is sometimes likened to passing small fragments of broken glass. Men may exhibit blood in the urine (hematuria); this is less common in women with urethritis. Pus may also be present in the urine (pyuria), and the individual may experience urinary urgency or frequency. In men, intercourse and ejaculation may be painful, and semen may be bloodstained. When caused by a bacterial infection, particularly gonorrhea, there is often a yellow, pus-filled discharge from the penis.

Physical exam: In men, swelling and tenderness may be noted in the testes (orchitis), epididymis (epididymitis), prostate (prostatitis), or general groin area. In the case of sexually transmitted urethritis caused by gonorrhea or Chlamydia, the individual should be examined for evidence of systemic disease, including fever, rash, or pain and swelling in the joints. The lymph nodes in the groin area (inguinal) may also be tender and enlarged (lymphadenopathy).

Tests: Triple-void urine specimens will be obtained for urinalysis and culture and to exclude bladder infection (cystitis). Urine will also be checked for blood, white blood cells, or bacterial growth. Urethral discharge may also be cultured to determine the identity of the pathogen causing the urethritis.

Source: Medical Disability Advisor



Treatment

Urethritis caused by gonorrhea and other bacterial infections is usually successfully treated by antibiotic therapy. Since Chlamydia often occurs at the same time as a gonococcal infection (dual infection), effective treatment may also include an effective antichlamydial regimen. Because antibiotic-resistant (penicillin-resistant and tetracycline-resistant) forms of certain infections are on the increase, an antibiotic susceptibility test should be performed at the same time the infective agent is cultured (culture and sensitivity). Urethritis caused by viruses or protozoa is treated with specific drugs such as antiviral or antiprotozoal agents. Since most urethritis is sexually transmitted, abstinence from sexual intercourse or the use of condoms is recommended throughout the course of treatment. It is also imperative to evaluate and treat sexual partners. Antibiotic therapy may also be needed if a bacterial infection follows urethritis due to a noninfectious cause. Urethritis caused by trauma or chemical irritants is treated by avoiding the precipitating factors. Analgesic pain relievers and urinary tract-specific analgesics (phenazopyridine) may also be taken concurrently with antibiotics.

Source: Medical Disability Advisor



Prognosis

With prompt, accurate diagnosis and antibiotic treatment, urethritis usually clears up without any complications. The individual should be instructed concerning the spread of STIs in order to prevent recurrence. Left unresolved, urethritis may result in lifelong damage to the genital or urinary organs in both sexes.

Source: Medical Disability Advisor



Complications

Complications of gonococcal urethritis in men include inflammation of the epididymis and testes (acute epididymo-orchitis), inflammation of the lymph vessels in the penis (penile lymphangitis), inflammation of the prostate gland (prostatitis), and narrowing of a section of the urethra due to scarring (inflammatory urethral stricture). Untreated gonococcal or chlamydial urethritis in women is thought to cause ascending genitourinary infections, which may result in cervicitis, infection of the fallopian tubes (salpingitis), pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. In both sexes, urethritis may proceed up the genitourinary tract to develop bladder infection (cystitis) or kidney infection (pyelonephritis).

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions or special accommodations are not usually associated with this condition.

Risk: Risk may be affected by the underlying disease or condition contributing to the urethritis. If the source of infection is an STI, the individual may need to be educated in lifestyle changes to help prevent recurrence. Sex workers and pornography actors are at risk for recurrence.

Capacity: Capacity is typically unaffected by urethritis. Most individuals will be able to work normally.

Tolerance: Tolerance is not expected to be a factor. The majority of individuals with urethritis will choose to work despite discomfort, if present, although tolerance may be temporarily reduced if systemic disease is present.

Source: Medical Disability Advisor



Maximum Medical Improvement

7 days.

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:

  • Has diagnosis of urethritis been confirmed with laboratory tests?
  • Were blood, pus, or white blood cells noted in a urinalysis?
  • Was urethral discharge cultured to identify a source of infection?
  • Have urinary tract infections and other disorders of the pelvic region been ruled out?

Regarding treatment:

  • Were infectious sources of urethritis treated with appropriate antibiotics?
  • Do symptoms persist despite treatment?
  • Has infective organism been identified?
  • Is dual infection present?
  • Has culture and sensitivity been done to determine the most effective antibiotic?
  • Have antibiotic-resistant organisms been ruled out?
  • Can antibiotics be administered by injection rather than orally?
  • If HSV is the causative organism, would the individual benefit from treatment with an antiviral drug, such as acyclovir?
  • Have sexual partners been treated simultaneously to prevent reinfection?
  • Have possible chemical irritants (spermatocides) been identified and eliminated?

Regarding prognosis:

  • Have symptoms persisted despite treatment?
  • Were cultures repeated to rule out the possibility of reinfection or bacterial resistance?
  • Has individual been compliant with drug therapy? If not, what can be done to enhance compliance?
  • Have chemical irritants been ruled out?
  • Has individual experienced any complications (urinary tract or reproductive infection or inflammation) related to the urethritis that could affect recovery and prognosis?
  • Is individual continuing to engage in unprotected sex?

Source: Medical Disability Advisor



References

Cited

Terris, Martha, and Kamran P. Sajadi. "Urethritis." eMedicine. 4 Mar. 2015. Medscape. 29 Jul. 2015 <http://emedicine.medscape.com/article/438091-overview>.

Source: Medical Disability Advisor






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