% WPI

Criteria

0

Occasional interference with sexual function.

10

Sexual function possible but always with a degree of difficulty with erection, ejaculation and/or sensation.

15

Sexual function possible in that there is sufficient erection but sensation and/or ejaculation is absent.

20

No sexual function is possible.

% WPI

Criteria

0

Symptoms and/or signs of scrotal loss or disease with no evidence of testicular malfunction, malposition or loss of mobility.

5

Symptoms and/or signs of scrotal loss or disease with no evidence of testicular malfunction but with testicular malposition or loss of mobility.

10

Total loss of scrotum;

or

Symptoms and signs of scrotal loss or disease with necessity for testes to be implanted elsewhere to preserve testicular function.

15

Symptoms and signs of scrotal loss or disease with necessity for testes to be implanted elsewhere to preserve testicular function;

and

Scrotal pain or discomfort present with physical activity.

20

Symptoms and signs of scrotal loss or disease unable to be controlled by treatment

and

Scrotal pain severely limits physical activity.

% WPI

Criteria

0

Symptoms and signs of testicular, epididymal and/or spermatic cord dysfunction are present and there is anatomic alteration;

and

Continuous treatment is not required and there are no seminal or hormonal abnormalities.

5

Loss of one testis

10

Symptoms and signs of testicular, epididymal and/or spermatic cord dysfunction are present and there is anatomic alteration;

and

Continuous or frequent treatment is required, or treatment is not possible;

and

There are no seminal or hormonal abnormalities.

15

Symptoms and signs of testicular, epididymal and/or spermatic cord dysfunction are present and there is anatomic alteration;

and

Continuous or frequent treatment is required, or treatment is not possible;

and

There is no detectable seminal or hormonal function.

20

Loss of both testes.

% WPI

Criteria

0

Symptoms and signs of prostate and/or seminal vesicle disease or dysfunction are present

and

there is anatomic alteration;

and

Continuous or very frequent treatment not required.

10

Frequent and severe symptoms of prostate and/or seminal vesicle disease or dysfunction are present;

and

There is anatomic alteration;

and

Continuous or very frequent treatment not required.

15

Prostatectomy.

% WPI

Criteria - Pre-menopausal

Criteria - Post-menopausal

0

Symptoms and signs of disease or deformity of the vulva and/or vagina are present;

and

Continuous treatment is not required;

and

Sexual intercourse is possible;

and

The vagina is adequate for childbirth.

Symptoms and signs of disease or deformity of the vulva and/or vagina are present;

and

Continuous treatment is not required;

and

Sexual intercourse is possible with or without considerable difficulty.

15

Symptoms and signs of disease or deformity of the vulva and/or vagina are present;

and

Continuous treatment is required;

and

Sexual intercourse is possible only with difficulty;

and

Limited potential for vaginal delivery.

Symptoms and signs of disease or deformity of the vulva and/or vagina are present;

and

Continuous treatment is required and may not control symptoms;

and

Sexual intercourse is not possible.

25

Symptoms and signs of disease or deformity of the vulva and/or vagina are present;

and

Continuous treatment does not control symptoms;

and

Sexual intercourse is not possible;

and

Vaginal delivery is not possible.

% WPI

Criteria - Pre-menopausal

Criteria - Post-menopausal

0

Symptoms or signs of disease or deformity of cervix and/or uterus present;

and

Continuous treatment not required;

or

Cervical stenosis not requiring treatment.

Cervical stenosis.

Anatomical loss of cervix and/or uterus.

5

Symptoms and signs of disease or deformity of cervix and/or uterus present;

and

Continuous treatment required.

10

Symptoms and signs of disease or deformity of cervix and/or uterus present;

and

Continuous treatment required.

Symptoms and signs of disease or deformity of the cervix and/or uterus present;

and

Treatment does not give control.

15

Cervical stenosis requiring periodic treatment.

25

Symptoms and signs of disease or deformity of cervix and/or uterus present;

and

Treatment does not control symptoms;

or

Complete cervical stenosis.

30

Total hysterectomy;

and/or

Amputation of cervix.

% WPI

Criteria - Pre-menopausal

Criteria - Post-menopausal

0

Symptoms or signs of disease or deformity of the fallopian tubes or ovaries present;

and

Continuous treatment not required;

and

No difficulties with conception or loss of one ovary.

Symptoms or signs of disease or deformity of the fallopian tubes or ovaries present;

and

Continuous treatment not required;

or

Unilateral or bilateral loss of one or both fallopian tubes and/or one or both ovaries.

5

Symptoms or signs of disease or deformity of the fallopian tubes or ovaries present;

and

Continuous treatment not required;

and

Conception possible with medical intervention;

or

Loss of one fallopian tube.

Symptoms or signs of disease or deformity of the fallopian tubes or ovaries present;

and

Continuous treatment required.

10

Symptoms or signs of disease or deformity of the fallopian tubes or ovaries present;

and

Continuous treatment required;

and

Conception is possible although medical intervention may be required.

Symptoms or signs of disease or deformity of the fallopian tubes or ovaries present;

and

Continuous treatment does not give control.

20

Bilateral loss of both fallopian tubes;

or

Irreparable loss of patency of both fallopian tubes.

30

Loss of both ovaries;

or

Failure to produce ova despite treatment.