Diagnostic Code 7622 · 38 CFR §4.116
Displacement of the uterus is an older term in 38 CFR §4.116 that captures uterine positioning abnormalities — uterine prolapse (descent of the uterus into the vaginal canal due to weakened pelvic floor support), severe retroverted or retroflexed uterus producing symptoms, and certain post-surgical adhesion-related displacements. Pelvic floor dysfunction is the most common cause and is increasingly common in women veterans because of factors that overlap with service: heavy lifting and rucking, prior pregnancies, chronic increased intra-abdominal pressure from sustained physical demands, and pelvic trauma. Symptoms include pelvic pressure or heaviness, low back pain that worsens with standing or activity, dyspareunia, urinary frequency or urgency, and in advanced prolapse a visible or palpable bulge from the vagina. Treatment ranges from pelvic floor physical therapy and pessary fitting for mild-to-moderate cases to surgical repair (vaginal hysterectomy, sacrocolpopexy, sacrospinous fixation) for advanced cases. DC 7622 rates the residual symptoms.
| Rating | Criteria |
|---|---|
| 0% | Mild displacement without significant symptoms — incidental finding on examination, no functional impairment, no treatment required. |
| 10% | Moderate displacement — definite pelvic pressure or pain, intermittent dyspareunia, urinary frequency or stress incontinence, controlled by pelvic floor therapy or pessary use. |
| 30% | Severe displacement — advanced prolapse with visible or palpable vaginal bulge, persistent pelvic pain, significant urinary or bowel dysfunction, dyspareunia limiting sexual function, OR status post-surgical repair with significant residual symptoms. |
A gynecological examination grading the prolapse (POP-Q grade for pelvic organ prolapse) is the central evidence. Urodynamic testing characterizes any associated urinary dysfunction. Pelvic imaging (MRI, ultrasound) may add detail in complex cases. Records of pelvic floor physical therapy attempts, pessary fitting and management, and any surgical repair document the disease course. A symptom diary captures functional impact on daily activity. Service treatment records establishing the in-service onset of pelvic floor symptoms or trauma support service connection.
The 38 CFR §4.116 schedule was last comprehensively revised some years ago, and the terminology reflects older clinical conventions. Modern gynecological terminology uses the POP-Q (Pelvic Organ Prolapse Quantification) grading system and characterizes prolapse by which organs descend (cystocele, rectocele, enterocele, vaginal vault prolapse, uterine prolapse). The VA rates these under DC 7622 by analogy, with the symptom severity and treatment burden driving the rating tier regardless of the specific terminology used in the clinical record.
Yes, sustained and repeated heavy lifting is a recognized contributing factor to pelvic floor weakness and subsequent prolapse. The mechanism is repeated increases in intra-abdominal pressure stretching the pelvic floor supports over time. Service connection through this pathway requires documenting both the in-service exposure (MOS history showing heavy lifting, rucking, sustained physical demands) and the in-service onset of pelvic symptoms or post-service development consistent with the exposure pattern.
Recurrence after surgical repair is common, particularly with sustained physical demands or pregnancies after repair. A recurrence is treated as a continuation of the original condition for service connection purposes (the connection runs through the underlying pelvic floor weakness, not through each individual prolapse event). Documented recurrence supports keeping the rating at the appropriate tier or increasing it; multiple recurrences support the higher 30% tier.