Perinatal testicular torsion: some facts and figures

ABSTRACT

Perinatal testicular torsion is a different entity from testicular torsion in the general paediatric population. Delay in management may result in testicular loss and grave consequences like anorchia. To determine the effectiveness of immediate surgical exploration in salvaging perinatal testicular torsion. A retrospective analysis was carried out between July 2003 to June 2008 on 11 surgically proved neonates with testicular torsion. All neonates underwent immediate surgical exploration irrespective of duration of symptoms. If a nonviable testis was determined intraoperatively, it was removed, otherwise detorsion and orchiopexy was done and at the same time contralateral orchiopexy was performed. Eleven patients underwent immediate surgical exploration. In 4 [36%], testis could be salvaged. In these patients duration of symptoms was less than 12 hours. Seven [64%] underwent orchiectomy due to trank necrosis, later on proved by histopathology. Neonates younger than 30 days of age presenting with clinical findings suggestive of extravaginal testicular torsion who are expeditiously explored surgically may have a high salvage rate. Time should not be wasted in undue investigations. Urgent bilateral exploration is strongly advised in all newborns presenting with either unilateral or bilateral torsion. Such policy carries diagnostic, potential therapeutic and prognostic implications