Bilateral torsion of the testes in a newborn infant

ABSTRACT

We report one case of bilateral testicular torsion. A 400 gm male infant, born by cesarean section due to induction failure at 42 weeks gestation, was hospitalized at 9 days of age secondary to bilateral testicular mass. Physical examination revealed an healthy baby with enlarged, firm, nontender mass on both sides of the scrotum. Transillumination of the mass showed no transmission of light. Laboratory data included a normal CBC and a urinalysis. Ultrasonogrophy showed well encapsulated 0.9 x 0.9 x 1.0 cm sized and 1.5 x 1.3 x 1.3 cm sized homogenous hypoechoic solid mass in left and right testicles respectively, remainder testicular parenchyme showed normal structure. Exploration of the testes was performed at 25-days old under general anesthesia. Exploration revealed a infarction of the right testes secondary to spermatic cord torsion, evidenced by clockwise turns outside the tunica vaginalis of 270 degrees. Left testes was infarcted but a quarter of them seemed normal. Orchiectomy on right and fixation on left testes were performed respectively. Left spermatic cord seemed to be detorted spontaneously. Postoperatively the infant did well and discharged 5 days after operation. Follow up examination during the next 3 months have shown appropriated sized testicle with normal colorization and arterial pulse. Testicular scan performed at age 39 days showed good perfusion of left testes.