Perinatal Testicular Torsion: Preoperative Radiological Findings And The Argument For Urgent Surgical Exploration

Main Category: Urology / Nephrology
Article Date: 02 Oct 2008 - 3:00 PDT

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UroToday.com - A study conducted at the University of California, San Diego described two cases in which bilateral asynchronous perinatal torsion occurred when the only presenting abnormality after birth was a unilateral scrotal mass consistent with an extravaginal intrauterine torsion.

The review of the literature to date has stated that there seems to be no benefit from early intervention. However based on this study, one must believe that there is a risk without intervention. It has been our experience here at the University of Pennsylvania, as well at The Children's Hospital of Philadelphia, that perinatal testicular torsion can occur. The majority of us in our practice do handle these cases - either on an emergent or an urgent basis. The risk of general anesthesia to an infant in a well-versed pediatric hospital is extremely minimal.

We cannot ignore the fact that loss of both testes is a very debilitating scenario. Informed consent and the option to either observe or to operate must be discussed with the family and disclosed carefully.

Ahmed SJ, Kaplan GW, DeCambre ME
J Pediatr Surg. 2008 Aug;43(8):1563-5
doi:10.1016/j.jpedsurg.2008.03.056

Written by UroToday.com Medical Editor Pasquale Casale, MD

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