Condition

Urogenital congenital anomalies

Clinical trials and treatment information for Urogenital congenital anomalies

6.3M
People Affected
15
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.

1
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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50
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

6

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
2
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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65
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)

4

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
3
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)

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65
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

2

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
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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65
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
5
Orchiopexy for Cryptorchidism
97% Effectiveness• 95% Confidence• 70% Safety• 3 trials• 30K participants
HIGH EvidenceExcellent Value
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70
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
6
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)

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70
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