BERKELEY, CA (UroToday.com) - A review from the United Kingdom evaluated the records of 24 neonates who presented with signs of testicular torsion. These 24 patients were seen over a 13-year period. The babies had a mean birth weight of 3.7 kg. The right testis was affected in 13 while the left in 9 of the patients. There were two babies who had bilateral torsion.

Twenty-one babies had primary exploration revealing a necrotic testis in all of them and they all underwent orchiectomies on the affected side. The other 3 babies had conservative management and the affected testes had atrophied on follow-up. Of the 21 patients who had surgery, 16 of them had a contralateral septopexy. Of the entire cohort, 13 babies had Doppler ultrasound scans of which two were reported as completely normal. None of the affected testes were salvaged following surgery.

The group concluded that the incidence of testicular torsion in the neonatal period was low. Their experience showed that no testis was salvaged following surgery. Although they state that immediate surgical exploration, although commonly performed, rarely saves the torsed testis. I believe that it is not the salvageability of the affected side but the prophylactic safety of the contralateral side that needs to be addressed. Metachronous torsion of the contralateral testis is extremely rare, but when it does happen it is detrimental. Our current practice at this time is to operate urgently but not emergently.

Mathews JC, Kooner G, Mathew DE, Ahmed S, Kenny SE

Acta Paediatrica 97 (4):502-504, 2008
10.1111/j.1651-2227.2008.00701.x

PubMed Abstract
PMID: 18331368

UroToday.com Pediatric Urology Section

Written by Pasquale Casale, MD, a Contributing Editor with UroToday.

Please log-in or register in order to submit comments.

Powered by AkoComment!