Four Cases of Patients With Neonatal Testicular Torsion, Including One Patient Suspected of Having Bilateral Asynchronous Onset

Abstract

There are no standardized treatment strategies for neonatal testicular torsion, which include emergency surgery or contralateral orchiopexy. We experienced treating four cases of patients with neonatal testicular torsion, including one patient suspected of having bilateral asynchronous onset. Four male infants were found to have swelling of the scrotum within 10 days of birth and underwent surgical removal or fixation of the affected-side testis by emergency operation. One patient was found to have contralateral testicular atrophy with microcalcification by a regular ultrasonography checkup at 5 years of age. In that patient, bilateral asynchronous neonatal testicular torsion was suspected. From our experience with this patient, another patient underwent intraoperative exploration and orchiopexy of the contralateral testis. Most cases of neonatal testicular torsion occur during the fetal period. Even with emergency surgical intervention, the salvage rate of the testis is extremely low. In addition, 7% of cases of neonatal testicular torsion are bilateral, and most have an asynchronous onset detected by contralateral surgical exploration. Therefore, the contralateral testis can be salvaged by emergency surgical exploration and orchiopexy. Since bilateral torsion leads to anorchia and loss of fertility, emergency contralateral exploration with orchiopexy is recommended.