Neonatal testicular torsion

Sheikh, Yusra; Jubarah, Ibrahim

doi:10.53347/rid-71150

Cited by 2 publications

(6 citation statements)

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“…Testicular torsion is often thought of as an event that occurs during pubertal years; however, the second peak incidence of testicular torsion occurs in the neonatal period, accounting for 10-12 percent of all cases of pediatric testicular torsion. 1 The mechanism of NTT as well as the associated clinical and surgical findings are quite different from those seen in testicular torsion in other age groups; further, and unfortunately, the outcomes are quite different as well. 3 Most notably, older children and adults with testicular torsion present with an abrupt onset of severe testicular or scrotal pain that is highly suggestive of testicular torsion and leads to urgent evaluation and management 4 ; however, NTT is not often associated with obvious infant distress.…”

Section: Discussionmentioning

confidence: 95%

“…3 Most notably, older children and adults with testicular torsion present with an abrupt onset of severe testicular or scrotal pain that is highly suggestive of testicular torsion and leads to urgent evaluation and management 4 ; however, NTT is not often associated with obvious infant distress. It is thought that the increased mobility of the neonatal tunica vaginal is within the scrotum during the first month of life as well as an increased cremasteric reflex makes the neonatal testicle more susceptible to torsion along the long axis of the spermatic cord resulting in extra vaginal torsion [1]. This alone, though, is not thought to explain the full breadth of the risk of NTT as it remains a rare event, even among infants born prematurely.…”

Section: Discussionmentioning

confidence: 99%

“…It is known that approximately 70-80 percent of cases of NTT occur prenatally; postnatal torsion is exceedingly rare [5]. By definition, postnatal testicular torsion presents as acute swelling, tenderness, and overlying scrotal changes in a testicle that was previously noted to be normal [1]. This, however, is difficult to determine when provider continuity is non-existent and a normal-to-abnormal physical exam cannot be confirmed.…”

Section: Discussionmentioning

confidence: 99%

“…NTT is a rare event; however, failure to promptly diagnose and treat this event can lead to vascular compromise, ischemia, and testicular loss. 1 Defined as occurring in the first 30 days of life, NTT can have varying presentations depending on the timing of the torsion itself, either early prenatal, late prenatal, or postnatal torsion [1]. The clinical exam findings and therefore likely timing of the torsion are important in determining management as optimal management remains controversial as to whether or not the affected testicle can be salvaged [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…1 Defined as occurring in the first 30 days of life, NTT can have varying presentations depending on the timing of the torsion itself, either early prenatal, late prenatal, or postnatal torsion [1]. The clinical exam findings and therefore likely timing of the torsion are important in determining management as optimal management remains controversial as to whether or not the affected testicle can be salvaged [1,2]. It has been postulated that fetal stress during pregnancy and or/delivery can be associated with NTT and it is known that vaginal delivery, gestational diabetes, and higher birth weight have all been linked to a higher risk of NTT [3] .…”

Section: Introductionmentioning

confidence: 99%

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Neonatal Testicular Torsion Associated with Neonatal Stress: A Case Report

2024

Arch Pediatr

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Introduction: Neonatal testicular torsion (NTT) is a rare but critical condition requiring prompt diagnosis and intervention to prevent testicular loss. Though rare, it accounts for greater than ten percent of testicular torsion cases in the pediatric population. Case Presentation: A 4-day old, ex-36-week gestational age, male infant was admitted to the neonatal intensive care unit (NICU) for hyperbilirubinemia and choking episodes at home. He was the product of a difficult vaginal delivery associated with clavicular fracture. On day two of admission, a firm left testicle and a right hydrocele were noted. There were no signs of distress, tenderness to palpation, nor scrotal color change during the exam. An ultrasound revealed diminished blood flow to the left testicle with morphology suggestive of NTT and a large right hydrocele. The infant was taken to the operating room where left testicular torsion was confirmed; a necrotic left testicle was unsalvageable. Pathology revealed hemorrhagic necrosis without malignancy. Conclusion: Testicular torsion in the newborn period is rare and often difficult to diagnose as there are varying clinical presentations and the infant does not display signs of distress. It has been postulated that fetal stress during pregnancy or delivery is a predisposing factor for NTT; however, little research has been done on whether postpartum stress can contribute to NTT. This case highlights a neonate with testicular torsion discovered following both a stressful delivery and choking event at home. It underscores the importance of considering NTT in neonates with abnormal testicular exam findings, particularly those with stressful deliveries and/or clinical histories.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Neonatal Testicular Torsion Associated with Neonatal Stress: A Case Report

2024

Arch Pediatr

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Neonatal Testicular Torsion with Hydrocele: A Case Report Underscoring the Need for Early Recognition and Management

Omran,

Ali,

Ahmad

et al. 2023

Case Reports in Surgery

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Neonatal testicular torsion (NTT) is a rare but significant condition occurring within the first 30-day postbirth, leading to vascular compromise and potential testicular loss. This paper presents a case of NTT detected incidentally in a neonate with bilateral hydrocele, emphasizing the challenge of early diagnosis and management complexities. The infant underwent surgical intervention involving detorsion and bilateral orchiopexy but eventually required right orchiectomy due to necrosis. The paper highlights the prevalence of NTT in conjunction with hydrocele and stresses the importance of parent education and vigilant follow-up. Various diagnostic methods, primarily ultrasonography, and a range of management strategies are discussed, considering factors such as salvage potential, risk to the contralateral testicle, and surgical intervention’s risks and benefits. The paper argues for individualized management, taking into account specific neonate conditions and parental preferences, underlining the essential role of informed and empathetic consultation. The case reinforces the urgent need for increased awareness, early detection, and carefully considered therapeutic approaches to prevent devastating outcomes like infertility and the necessity for lifelong hormone supplementation.

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Neonatal testicular torsion

Cited by 2 publications

References 0 publications

Neonatal Testicular Torsion Associated with Neonatal Stress: A Case Report

Neonatal Testicular Torsion Associated with Neonatal Stress: A Case Report

Neonatal Testicular Torsion with Hydrocele: A Case Report Underscoring the Need for Early Recognition and Management

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