Bilateral asynchronous perinatal testicular torsion: A case report

Olguner, Mustafa; Akgür, Feza M.; Aktuğ, Tanju; Derebek, Erkan

doi:10.1053/jpsu.2000.9330

Cited by 42 publications

(34 citation statements)

References 8 publications

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“…Many studies recommend that in newborns who present with suspected unilateral testicular torsion within the fi rst 30 days of age, the risks associated with early surgery and anesthesia outway the prospect of salvaging the testis (4). It is now clear that the potential untoward anesthetic risks involving an otherwise healthy neonate quoted in prior studies are outdated and are not consistent with the current standards of pediatric anesthetic practice (8). Th ere is diff erence between an acute torsion presenting aft er birth and the more common entity of the long standing event of antenatal testicular torsion.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Pogorelić

Jukić

Škrabić

et al. 2017

Acta Med. (Hradec Kralove, Czech Repub.)

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A B ST R AC T Introduction: Testicular torsion is a urological emergency. If not recognized in time, this condition may result in ischaemic injury and loss of testis. Simultaneous bilateral neonatal testicular torsion is extremely rare and is usually misdiagnosed. Case report: We report a case of a male newborn, who presented with bilateral scrotal swelling and redness of the scrotum. Doppler ultrasound supported the diagnosis of bilateral testicular torsion, with an absent blood flow signal on the right side and a weak signal on the left side. Testicular exploration through scrotal incision was performed and bilateral testicular torsion was found. Right testis was grossly gangrenous, and right orchiectomy was performed. Left testicle was dark but showed recovery after detorsion with some bleeding from incised tunica albugenia. Fixation of the left testicle was performed. At six month follow-up, the left testis showed signs of atrophy and hormonal assay showed very low testosterone and elevated LH and FSH, suggesting hypogonadism. Conclusions: Management of neonatal testicular torsion is a matter of controversy. Testicular torsion results into acute ischemia and urgent surgical exploration is the key point of management. Although the possibility of salvaging the involved testicles is usually very low it is hard to justify a passive approach to a bilateral torsion resulting in such a devastating condition as anorchia.K E Y WO R D S testicular torsion; neonatal torsion; newborn; bilateral testicular torsion; simultaneous testicular torsion

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Section: Discussionmentioning

confidence: 99%

“…Another reason to remove the infarcted testicle is to minimize the chance of aptoposis of the germinal epithelium in the contralateral testicle (5). Many authors adopted the policy of early surgical intervention (5,8,10,11). John et al reviewed the literature on neonatal testicular torsion.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Pogorelić

Jukić

Škrabić

et al. 2017

Acta Med. (Hradec Kralove, Czech Repub.)

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“…One can wait in unilateral torsion, but urgent surgery is recommended in bilateral torsion to protect the remaining healthy testicular tissue (2). Some advocate urgent surgery even if the torsion is unilateral to protect the other testicle from future torsion (8). Since the testicle has a chance of being saved, …”

Section: Discussionmentioning

confidence: 99%

A newborn with antenatal testis tortion

et al. 2014

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IntroductionNeonatal testicular torsion (NTT) includes cases which occur in the first 30 days of life and is divided into two groups as prenatal and postnatal torsion. Prenatal testicular torsion develops in the intrauterine period and its etiology has not been elucidated fully. Prenatal testicular torsion is diagnosed at birth or on the first examination of the baby. In the postnatal testicular torsion, the first examination of the baby is normal and a firm testis is palpated in the follow-up. The incidence of neonatal testicular torsion is 6.1/100 000 (1) and it constitutes 10-22% of childhood testicular torsions (2). Prenatal cases are observed more rarely; there is no information about the incidence. In the literature, less than 200 cases of prenatal testicular torsion have been reported. On physical examination, discolouration in the scrotum and firm testiscle are observed. Only 0-5% of prenatal torsions can be saved (2). However, it should be kept in mind that shortening of the time between the diagnosis and operation is important in terms of saving the testicle in cases of NTT. Here, a newborn who underwent orchiectomy because of prenatal testicular torsion was presented and the importance of detailed examination of the genital organs on the first physical examination was emphasized. CaseThe first and fifth minute Apgar scores of a baby born at the 35th gestational week from the first pregnancy of a 46-year old mother following in vitro fertilization were 8 and 9, respectively. In the prenatal period, the mother had gestational diabetes. The baby was admitted to the Neonatal Intensive Care Unit becasue of respiratory distress and preterm delivery and monitored with mechanical ventilation. On the first physical examination, the body weight was found to be 3 390 g (>97p), the height was found to be 52 cm (>97p), the head circumference was found to be 35.5 cm (>97p). The respiratory rate was 70/min, the heart rate was 140/min, the body temperature was 36.5°C and the blood pressure was measured to be 55/35 mmHg. There was hydrocele in the right scrotum as seen on Figure 1 which was taken after obtaining consent from the family. The right testicle had a size of 10x10 mm. The skin of the left testicle was darker than normal and a firm mass with a size of 15x15 mm was palpated in the scrotum (Figure 1). The left testicle was firmer and located more upwards compared to the right testicle. Paratesticular structures could not be differentiated fully. Since the patient was mechanically ventilated and receiving fentanyl infusion, it could not be fully evaluated if the testicular structures were painful. Other examination findings were normal. In the laboratory tests, complete blood count, blood glucose, blood gases, hepatic and renal functions were found to be normal. Scrotal Doppler ultrasonography revealed that both testicles were in the scrotum, the right testicle had a size of 7x7 mm and AbstractTestis tortion in the newborn (especially antenatal testis tortion) is observed very rarely and constitutes 10-12% of ...

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“…Ischemic organs may profit from conservative treatment, and regain full or near-full endocrine status [8,9]. This is especially important in the rare cases of bilateral torsion, where the danger of retarded development, slower body growth, missed puberty and infertility are common [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Perinatal testicular torsion—An emergency with grave consequences

Doll¹,

Erkel²,

Erhart³

et al. 2013

CRCM

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Introduction: Perinatal testicular torsion is not a frequent, but a grave finding finding. As only immediate surgical retorsion may save the viability of the testicle, time is of essence. We report the case of a newborn where delayed diagnosis led to an unnecessary loss of one testicle. Presentation of Case: The newborn was presented one day after delivery with a swollen left blue scrotal pouch. The left testicle was little tender, higher in position and enlarged. Ultrasound revealed a globular, enlarged testicle left, showing hypodense necrotic areas within. Doppler sound could not detect any perfusion of the spermatic vessels. Scrotal fluid was present bilaterally. At operation, the testicle was considered unsalvageable, and left orchiectomy and right orchidopexy were performed. Discussion: In the newborn, it is more than convenient to perfom ultrasound of both testicles at the same time, which allows to compare texture and perfusion easily. Immediate surgical exploration should be performed at any time, even if in diagnostic doubt. The very most important step though is to professionally recognise and to react to this pediatric emergency, as time is of paramount essence. Conclusion: A case of a male newborn with unilateral perinatal testicular torsion is presented, where typical clinical signs and ultrasound features can be seen. Early exploration with orchiectomy of the necrotic testicle and orchidopexy of the healthy side may save the endocrine function and fertility.

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Bilateral asynchronous perinatal testicular torsion: A case report

Cited by 42 publications

References 8 publications

Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

A newborn with antenatal testis tortion

Perinatal testicular torsion—An emergency with grave consequences

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