An abnormal opening between the urethra and vagina that may cause urine leakage.
Medical records that document the diagnosis and describe the number of fistulae present are central at every level. For the 100% rating, records confirming multiple urethrovaginal fistulae — such as imaging, operative reports, or cystoscopy findings — directly address the key criterion.
For the 20%, 40%, and 60% levels, the distinguishing factor is how often absorbent materials must be changed, or whether an appliance is needed. Urology or gynecology records, nursing notes, and treatment plans that specify the degree of urinary leakage and current management are helpful. A VA examination that documents your typical daily pad or appliance use ties directly to these thresholds.
Your own statements, and statements from caregivers or family members, describing how often you change absorbent materials throughout a typical day can also help show which rating level reflects your actual experience. If an appliance is prescribed, records from your provider documenting that prescription support the 60% criteria.
Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.
