There has been no consensus regarding the best surgical strategy for patients with cryptorchidism involving high-level intra-abdominal testes. This systematic review and meta-analysis compared the outcomes of Fowler-Stephens orchiopexy (FSO) conducted as 1-stage or 2-stage, open or laparoscopic. The databases PubMed, Cochrane Library, Web of Science Database, Russian Science Citation Index, SciELO Citation Index, China National Knowledge Infrastructure, WanFang Data, and China Biology Medical disc were systematically searched for relevant articles. Sixty studies involving 1991 operated testes were included in the final analysis. The overall success rates for 1- and 2-stage FSOs were 85% and 87%, respectively; overall atrophy rates for both were 10%. The success rates of 1-stage FSOs, open and laparoscopic, were 83% and 87%; with atrophy rates of 12% and 8%. The corresponding success rates of 2-stage FSOs were 81% and 89%; with atrophy rates of 17% and 8%. The odds ratios indicated that 2-stage FSO was significantly superior to 1-stage, and laparoscopic superior to open. Evaluating laparoscopic FSO over time, the success rates prior to year 2000, 2000 through 2010, and after 2010 were 85%, 89%, and 88%, and atrophy rates were 15%, 9%, and 6%, with no heterogeneity in the reports, and the funnel plot showed no publication bias. Each surgical technique for correcting high-level intra-abdominal testes (IATs) had an acceptable success rate, from 81% to 89%. However, in terms of highest success rate and lowest atrophy rate, 2-stage laparoscopic FSO is the first choice for treating high intra-abdominal cryptorchidism.

Background: To investigate the association between geographic, clinical, socioeconomic factors and delayed management of pediatric testicular torsion (TT) in West China. Methods: A retrospective study was conducted on TT at Children’s Hospital of Chongqing Medical University in West China from November 2004 to December 2020. Univariate analysis and logistic regression analysis were conducted to determine the association between these factors and delayed management of TT. Results: A total of 301 cases were included in this study. The misdiagnosis rate of TT in primary, secondary healthcare units and tertiary hospitals was 93.8, 71.1, and 8.9%, respectively. Approximately 26.9% of TT boys received timely surgical management (within 12 h from symptoms inset to surgery). Logistic regression analyses suggested the following factors were associated with delayed repair of TT: age less than 6 years (P = 0.001), with a history of symptoms progress (P = 0.001) or former treatment (P <0.001), absence of other diagnosis (P = 0.011) and those boys living far away from the main city zones (P <0.001). Conclusions: Delayed surgical management for TT was more likely for boys with age less than 6 years, the absence of other diagnosis, with a history of former treatment or symptoms progress, and those living far away from the main city zone. To maximize the possibility of timely surgical management for TT, it is vital to strengthen the public awareness of TT and conduct continuously re-education and update physicians working at primary and secondary healthcare units.

Most children with a neurogenic bladder (NB) have bladder fibrosis, which causes irreversible bladder dysfunction and damage to the upper urinary tract. However, the mechanism of bladder fibrosis remains unclear. This study aimed to investigate the underlying causes of bladder fibrosis. Here, the lumbar 6 (L6) and sacral 1 (S1) spinal nerves of Sprague Dawley rats were severed bilaterally to establish NB models. Using RNA-seq, we discovered that the NF-κB signaling pathway and inflammation were upregulated in spinal cord injury (SCI)-induced bladder fibrosis. Subsequent Western blotting, enzyme-linked immunosorbent assays, immunohistochemical staining, and immunofluorescence staining verified the RNA-seq findings. To further clarify whether the NF-κB signaling pathway and pyroptosis were involved in bladder fibrosis, a TGF-β1-treated urinary epithelial cell line (SV-HUC-1 cells) was used as an in vitro model. Based on the results of RNA-seq, we consistently found that the NF-κB signaling pathway and pyroptosis might play important roles in TGF-β1-treated cells. Further experiments also confirmed the RNA-seq findings in vitro. Moreover, using the NLRP3 inhibitor MCC950 rescued TGF-β1-induced fibrosis, and the NF-κB signaling pathway inhibitor BAY 11-7082 effectively rescued TGF-β1-induced pyroptosis and the deposition of extracellular matrix by SV-HUC-1 cells. In summary, our research demonstrated for the first time that the NF-κB signaling pathway inhibition rescued bladder epithelial cells pyroptosis and fibrosis in neurogenic bladders.