Condition

Urogenital congenital anomalies

Clinical trials and treatment information for Urogenital congenital anomalies

6.3M

People Affected

Active Trials

800K

New Cases/Year

7,495

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Reconstructive Surgery for Bladder Exstrophy

90% Effectiveness• 90% Confidence• 50% Safety• 2 trials• 5K participants

MODERATE EvidenceExcellent Value

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Comparative Safety Scale(Higher is safer)

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Meth💀

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DangerousModerateSafe

Time to Effect

Immediate anatomical correction, functional continence achieved over years with multi-stage surgeries

Duration

Multiple surgeries over childhood (birth to adolescence), lifelong follow-up

Response Rate

70%

Remission Rate

Common Side Effects:

Bladder prolapse: 10%

Bladder neck incontinence: 30%

Urinary tract infection: 35%

Urethral stricture/fistula: 15%

Renal deterioration: 15%

Reoperation for complications: 60%

Annual Cost of Care

Drug Cost

$1,000

Monitoring

$5,000

Side Effects

$10,000

Total Annual

$100,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

Cost per Responder

$142,857

Treatment Outcomes

Primary Outcomes

Functional Bladder Capacity (mL)40 mL

+250% (+100 mL)

Annual Urinary Tract Infection Rate4 episodes/year

-75% (-3 episodes/year)

Hydronephrosis Severity Score (0-4 scale)2.0 (moderate hydronephrosis)

-50% (-1.0 point)

Secondary Benefits

Pediatric Quality of Life Inventory (PedsQL) Score50/100

+40% (+20 points)

Parental Stress Index (PSI) Score80/120

-25% (-20 points)

Patient/Parent Reported Cosmetic Outcome Scale (0-10)3/10 (poor appearance)

+100% (+3 points)

Common Side Effects

Bladder prolapse

+10%

Bladder neck incontinence

+30%

Urinary tract infection

+35%

Clinical Trial Phases:

Phase 4

Ureteral Reimplantation for Vesicoureteral Reflux (VUR)

96% Effectiveness• 92% Confidence• 65% Safety• 400 trials• 25K participants

HIGH EvidenceExcellent Value

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

Immediate anatomical correction, reflux resolution confirmed post-op

Duration

Single surgery, follow-up for several years

Response Rate

96%

Remission Rate

96%

Number Needed to Treat (NNT)

Common Side Effects:

Bladder spasm/pain: 20%

Urinary tract infection (post-op): 8%

Temporary ureteral obstruction: 3%

Persistent VUR: 4%

Urinary retention: 3%

Annual Cost of Care

Drug Cost

$150

Monitoring

$3,500

Side Effects

$1,000

Total Annual

$18,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.8

ICER

$35,000/QALY

Cost per Remission

$18,750

Cost per Responder

$18,750

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+96%

Response Rate

+96%

Remission Rate

+96%

Common Side Effects

Bladder spasm/pain

+20%

Urinary tract infection (post-op)

+8%

Temporary ureteral obstruction

+3%

Clinical Trial Phases:

Phase 4

Endoscopic Valve Ablation for Posterior Urethral Valves (PUV)

90% Effectiveness• 90% Confidence• 65% Safety• 250 trials• 8K participants

MODERATE EvidenceExcellent Value

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

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DangerousModerateSafe

Time to Effect

Immediate relief of obstruction, renal function improvement over months

Duration

Single endoscopic procedure, lifelong follow-up for renal/bladder function

Response Rate

90%

Remission Rate

Common Side Effects:

Urethral stricture/scarring: 10%

Bladder dysfunction (neurogenic-like): 30%

Persistent vesicoureteral reflux: 25%

Urinary tract infection: 3%

Failure to completely ablate valves (requiring repeat): 8%

Annual Cost of Care

Drug Cost

$300

Monitoring

$2,000

Side Effects

$1,000

Total Annual

$10,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

Cost per Responder

$11,111

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+90%

Response Rate

+90%

Common Side Effects

Urethral stricture/scarring

+10%

Bladder dysfunction (neurogenic-like)

+30%

Persistent vesicoureteral reflux

+25%

Clinical Trial Phases:

Phase 4

Pyeloplasty for Ureteropelvic Junction (UPJ) Obstruction

96% Effectiveness• 92% Confidence• 65% Safety• 350 trials• 18K participants

HIGH EvidenceExcellent Value

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Comparative Safety Scale(Higher is safer)

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Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

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Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Immediate anatomical correction, functional improvement over months

Duration

Single surgery, stent for 2-6 weeks, follow-up for several years

Response Rate

96%

Remission Rate

Common Side Effects:

Urinary leak (requiring drainage): 3%

Urinary tract infection: 3%

Persistent obstruction (failure): 4%

Bleeding: 1%

Post-operative pain: 20%

Annual Cost of Care

Drug Cost

$150

Monitoring

$4,500

Side Effects

$1,000

Total Annual

$22,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.5

Cost per Responder

$22,917

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+96%

Response Rate

+96%

Common Side Effects

Urinary leak (requiring drainage)

+3%

Urinary tract infection

+3%

Persistent obstruction (failure)

+4%

Clinical Trial Phases:

Phase 4

Orchiopexy for Cryptorchidism

97% Effectiveness• 95% Confidence• 70% Safety• 3 trials• 30K participants

HIGH EvidenceExcellent Value

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Comparative Safety Scale(Higher is safer)

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Morphine💊

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DangerousModerateSafe

Time to Effect

Immediate repositioning, long-term benefits accrue over years

Duration

Single surgery, follow-up over years for testicular health

Response Rate

97%

Remission Rate

Common Side Effects:

Testicular atrophy: 3%

Ascending testis (requiring redo surgery): 2%

Wound infection: 0.5%

Bleeding: 0.5%

Annual Cost of Care

Drug Cost

$75

Monitoring

$450

Side Effects

$200

Total Annual

$6,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.2

Cost per Responder

$6,185

Treatment Outcomes

Primary Outcomes

Testicular Volume (affected testis)0.5 mL (pre-pubertal, average for cryptorchid testis)

+40% (+0.2 mL)

Sperm Concentration (unilateral cryptorchidism, adult follow-up)15 million/mL (mean for untreated unilateral cryptorchidism)

+100% (+15 million/mL)

Annual Incidence of Testicular Torsion5% (for cryptorchid testis)

-90% (-4.5 percentage points)

Inhibin B levels (indicator of Sertoli cell function)40 pg/mL (mean for cryptorchid patients, often reduced)

+50% (+20 pg/mL)

Secondary Benefits

Body Image Score (pediatric)Pediatric Body Image Scale score: 20/40 (lower scores indicate poorer body image)

+25% (+5 points)

Incidence of Associated Inguinal Hernia15% (estimated risk of clinical hernia associated with cryptorchidism)

-80% (-12 percentage points)

Serum Testosterone Levels (bilateral cryptorchidism, adult follow-up)250 ng/dL (mean for untreated bilateral cryptorchidism, often low)

+20% (+50 ng/dL)

Common Side Effects

Testicular atrophy

+3%

Ascending testis (requiring redo surgery)

+2%

Wound infection

+0.5%

Clinical Trial Phases:

Phase 4

Hypospadias Repair

88% Effectiveness• 88% Confidence• 70% Safety• 39 trials• 20K participants

MODERATE EvidenceGood Value

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Immediate anatomical correction, functional healing and full recovery 6-12 months

Duration

Single surgery (uncomplicated), follow-up for several years

Response Rate

88%

Remission Rate

Common Side Effects:

Urethrocutaneous fistula: 10%

Urethral stricture: 5%

Meatal stenosis: 8%

Wound infection: 2%

Cosmetic dissatisfaction: 10%

Annual Cost of Care

Drug Cost

$75

Monitoring

$750

Side Effects

$500

Total Annual

$9,325

Cost-Effectiveness

GOOD

QALYs Gained

0.8

Cost per Responder

$10,597

Treatment Outcomes

Primary Outcomes

Urethrocutaneous Fistula RateTypical rate without optimal repair: 15%

-66.7% (-10 percentage points)

Urethral Stricture RateTypical rate without optimal repair: 10%

-50% (-5 percentage points)

Residual Penile Curvature (Chordee)Mean pre-operative curvature: 45 degrees

-88.9% (-40 degrees)

Uroflowmetry Peak Flow Rate (Qmax)Pre-operative Qmax: 8 mL/s

+150% (+12 mL/s)

Meatal Stenosis RateTypical rate without optimal repair: 8%

-62.5% (-5 percentage points)

Secondary Benefits

Patient/Parent Satisfaction Score (e.g., HYPOSPADIAS-Q)Pre-repair distress/dissatisfaction: 30/100

+133.3% (+40 points)

Urinary Stream Deviation Score (0-5 where 0 is straight)Mean pre-operative deviation: 4/5

-75% (-3 points)

Body Image Satisfaction Score (0-10 scale)Pre-repair dissatisfaction: 3/10

+133.3% (+4 points)

Common Side Effects

Urethrocutaneous fistula

+10%

Urethral stricture

+5%

Meatal stenosis

+8%

Clinical Trial Phases:

Phase 4