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Article ; Online: Neonatal testicular torsion.

Kylat, Ranjit I / Ahmed, Mohamed N

African journal of paediatric surgery : AJPS

2021 Volume 19, Issue 1, Page(s) 1–4

Abstract: ... testicular torsion (TT). TT in the newborn infant in the 1st month of life is referred to as neonatal TT (NTT) or ... US) is mainly to exclude other conditions. If the timing of the torsion is prenatal, the testicle may not ... of torsion is not simultaneous (asynchronous torsion) early contralateral orchiopexy done at the time ...

Abstract	Rotation of the testis around the axis of the spermatic cord results in tissue ischaemia and testicular torsion (TT). TT in the newborn infant in the 1st month of life is referred to as neonatal TT (NTT) or perinatal TT and occurs in 6.1/100, 000 live births. The true incidence could be higher as some of these occur prenatally and can be asymptomatic. TT can be extravaginal, intravaginal and mesorchial and NTT is usually extravaginal. Physical examination can be adequate for the diagnosis, and utility of ultrasound (US) is mainly to exclude other conditions. If the timing of the torsion is prenatal, the testicle may not be salvageable. But, in certain situations, these could be asymptomatic bilateral TT. When the timing of torsion is not simultaneous (asynchronous torsion) early contralateral orchiopexy done at the time of exploration would prevent the occurence of asynchronous torsion. Non.operative maneuvres to detorse in NTT are not successful and not recommended. This review focuses on the diagnostic approach and management.
MeSH term(s)	Humans ; Infant, Newborn ; Male ; Spermatic Cord Torsion/diagnosis ; Spermatic Cord Torsion/surgery ; Testis
Language	English
Publishing date	2021-12-17
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2392865-7
ISSN	0974-5998 ; 0189-6725
ISSN (online)	0974-5998
ISSN	0189-6725
DOI	10.4103/ajps.AJPS_153_20
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Article: Neonatal epididymo-orchitis with pyocele mimicking testicular torsion: A case report.

Ayed, Abdullah / Alik, Abderrazak / Khan, Shahid / Ibrahim, Mutasim E

Urology case reports

2024 Volume 54, Page(s) 102702

Abstract: ... with amoxicillin and cefotaxime, a repeated ultrasound indicated compromised testicular vascularity, necessitating ... normal testicles but an enlarged, echogenic left epididymis with pyocele. Despite initial therapy ...

Abstract	We report a case of epididymo-orchitis (EO) in a 12-day-old Saudi boy. The neonate, initially diagnosed with hydrocele post-delivery, presented with left scrotal swelling. Doppler ultrasound revealed normal testicles but an enlarged, echogenic left epididymis with pyocele. Despite initial therapy with amoxicillin and cefotaxime, a repeated ultrasound indicated compromised testicular vascularity, necessitating emergency surgical exploration. This revealed purulent discharge and inflammation, with
Language	English
Publishing date	2024-03-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2745459-9
ISSN	2214-4420
ISSN	2214-4420
DOI	10.1016/j.eucr.2024.102702
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Article ; Online: Neonatal Paratesticular Abscess as the Greatest Mimicker of Testicular Torsion.

Delgado-Miguel, Carlos / Aguado, Pablo / Fuentes, Ennio / Díez, Ricardo

Urologia internationalis

2023 Volume 108, Issue 2, Page(s) 172–174

Abstract: ... may be considered as the greatest mimicker of testicular neonatal torsion, due to the frequent absence ... with scrotal abscess being great mimickers of testicular torsion.: Case presentation: We report a 12-day-old ... to these findings, surgical exploration was undertaken on suspicion of potential testicular torsion. Purulent ...

Abstract	Introduction: The management of acute scrotal swelling can be challenging in neonatal age, with scrotal abscess being great mimickers of testicular torsion. Case presentation: We report a 12-day-old previously healthy male infant who presented with 72 h of increasing right-sided scrotal swelling, without fever or irritable behavior. The left testicle was palpable, but the right side was too swollen to palpate a testicle, with absent cremasteric reflex. Biochemical analysis was normal and Doppler sonography demonstrated a hypoechogenic avascular lesion compressing the right testis, without intratesticular flow. Due to these findings, surgical exploration was undertaken on suspicion of potential testicular torsion. Purulent material was encountered and cultured. The testis and epididymis were covered by thick necrotic fibrinous exudate, with no spermatic cord torsion. Gentamicin and vancomycin were begun immediately. The patient remained afebrile and the scrotal induration gradually subsided. Urine and blood cultures were sterile. On the second postoperative day, cultures yielded Escherichia coli sensitive to gentamicin. One-month follow-up testicular ultrasound demonstrated complete inflammation resolution. Conclusion: Paratesticular abscess may be considered as the greatest mimicker of testicular neonatal torsion, due to the frequent absence of classical signs of inflammation. Early surgical exploration can be diagnostic and therapeutic and should be performed in these cases.
MeSH term(s)	Infant ; Infant, Newborn ; Humans ; Male ; Spermatic Cord Torsion/diagnostic imaging ; Abscess/diagnostic imaging ; Abscess/pathology ; Testis/pathology ; Scrotum ; Gentamicins
Chemical Substances	Gentamicins
Language	English
Publishing date	2023-12-29
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	204045-1
ISSN	1423-0399 ; 0042-1138
ISSN (online)	1423-0399
ISSN	0042-1138
DOI	10.1159/000536023
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Article ; Online: Coincidental occurrence of bilateral neonatal testicular torsion, with an extravaginal and a contralateral intravaginal testicular torsion.

Kirihana, Yusuke / Sato, Yuichi / Hata, Junya / Imai, Hitomi / Yoshida, Yuki / Matsuoka, Kanako / Hoshi, Seiji / Koguchi, Tomoyuki / Ogawa, Soichiro / Kojima, Yoshiyuki

IJU case reports

2023 Volume 6, Issue 6, Page(s) 465–467

Abstract: Introduction: We report a case of bilateral neonatal testicular torsion, with an extravaginal and ... swelling and palpable induration was diagnosed with bilateral neonatal testicular torsion ... a contralateral intravaginal testicular torsion.: Case presentation: A 5-day-old boy with bilateral scrotal ...

Abstract	Introduction: We report a case of bilateral neonatal testicular torsion, with an extravaginal and a contralateral intravaginal testicular torsion. Case presentation: A 5-day-old boy with bilateral scrotal swelling and palpable induration was diagnosed with bilateral neonatal testicular torsion by color Doppler ultrasonography. The right testis was black with 360-degree extravaginal torsion of the spermatic cord, and the left testis was brown with 90-degree intravaginal torsion. We repaired the torsion and incised the tunica albuginea to reduce intratesticular pressure. The left testis became pink in color, but the right testis remained unchanged. Based on the pathological findings of the intraoperative biopsy of tissue specimens from both testes, we performed a right orchiectomy and preserved the left testis. Conclusions: Our experience suggests that testicular color improvement after fasciotomy and pathological findings of intraoperative testicular biopsy may indicate testicular preservation.
Language	English
Publishing date	2023-09-28
Publishing country	Australia
Document type	Case Reports
ISSN	2577-171X
ISSN (online)	2577-171X
DOI	10.1002/iju5.12649
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Article ; Online: Perinatal testicular torsion presented as neonatal scrotal swelling.

Liao, Wei-Li / Chou, Chia-Man / Lin, Ming-Chih

Pediatrics international : official journal of the Japan Pediatric Society

2020 Volume 62, Issue 10, Page(s) 1202–1204

MeSH term(s)	Genital Diseases, Male ; Humans ; Infant, Newborn ; Male ; Scrotum ; Spermatic Cord Torsion ; Testis
Language	English
Publishing date	2020-09-03
Publishing country	Australia
Document type	Case Reports ; Journal Article
ZDB-ID	1470376-2
ISSN	1442-200X ; 1328-8067
ISSN (online)	1442-200X
ISSN	1328-8067
DOI	10.1111/ped.14283
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Article: Neonatal Testicular Torsion with Hydrocele: A Case Report Underscoring the Need for Early Recognition and Management.

Omran, Kareem / Ali, Sameh Ali / Ahmad, Ehsan / Matta, Hilal / Al Tamr, Wissam Jamal

Case reports in surgery

2023 Volume 2023, Page(s) 9979543

Abstract: 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 ...

Abstract	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.
Language	English
Publishing date	2023-12-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	2657697-1
ISSN	2090-6919 ; 2090-6900
ISSN (online)	2090-6919
ISSN	2090-6900
DOI	10.1155/2023/9979543
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Article ; Online: Regional Anesthesia. An Alternative to General Anesthesia in the Management of Neonatal Testicular Torsion.

Fernandez, Nicolas / Santander, Jessica / Ceballos, Cesar

Urology

2020 Volume 146, Page(s) 219–221

Abstract: We report a case of a 1-day-old male newborn with neonatal testicular torsion, in whom an immediate ... to a missed asynchronous torsion of the contralateral testis. ...

Abstract	We report a case of a 1-day-old male newborn with neonatal testicular torsion, in whom an immediate orchiectomy with prophylactic orchidopexy under caudal regional anesthesia was practiced. The aim of this report is to propose early surgical intervention with caudal regional anesthesia as an alternative in order to avoid possible side effects related to general anesthesia and the complications related to a missed asynchronous torsion of the contralateral testis.
MeSH term(s)	Anesthesia, Conduction ; Anesthesia, General ; Humans ; Infant, Newborn ; Male ; Orchiectomy ; Orchiopexy ; Spermatic Cord Torsion/surgery
Language	English
Publishing date	2020-07-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2020.06.037
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Zs.A 1142: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Bilateral Neonatal Testicular Torsion; Hidden Surgical Nightmare.

Abbas, Tariq O / Ali, Mansour

Frontiers in pediatrics

2018 Volume 6, Page(s) 318

Abstract: ... bilateral testicular torsion is suspected. Whenever possible, affected testes should be preserved ... Perinatal testicular torsion is a relatively rare event that remains unidentified ... We report a case of prenatal testicular torsion with incidentally discovered metachronous contralateral ...

Abstract	Perinatal testicular torsion is a relatively rare event that remains unidentified in many situations and managed only after an avoidable delay of time. Its current management approaches include watchful observation, delayed contralateral orchiopexy, and emergent contralateral orchiopexy. On the other hand, bilateral torsion is now being more frequently reported. However, the assessment of the contralateral testis through physical examination and imaging can be inaccurate in cases of perinatal torsion. We report a case of prenatal testicular torsion with incidentally discovered metachronous contralateral extravaginal testicular torsion. Therefore, immediate surgical intervention is recommended both when uni- or bilateral testicular torsion is suspected. Whenever possible, affected testes should be preserved as some endocrine function may be retained.
Language	English
Publishing date	2018-11-20
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2018.00318
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Article ; Online: Controversies in the management of neonatal testicular torsion: A meta-analysis.

Monteilh, Cecilia / Calixte, Rose / Burjonrappa, Sathyraprasad

Journal of pediatric surgery

2018 Volume 54, Issue 4, Page(s) 815–819

Abstract: ... testicular torsion (NTT).: Methods: Reviewed all English-language articles published between 2005 and 2015 ... testicular torsion (n = 85/97). Asynchronous NTTs (n = 9) were more common than synchronous NTTs (n = 2). There was ... of about 7% of ipsilateral testicles and prevent asynchronous torsion in about 4% of neonates.: Conclusions ...

Abstract	Objective: This meta-analysis seeks to discern the optimal management strategy in neonatal testicular torsion (NTT). Methods: Reviewed all English-language articles published between 2005 and 2015 in Medline/Pubmed that had a defined diagnosis of NTT within the first thirty days of life, and discussed specific surgical and nonsurgical management. Exclusion criteria were non-English literature, case reports, case studies, and failure to clearly describe the management of NTT. Data from 9 studies were analyzed, individually and together as pooled data, using a random effect model with a random intercept to estimate the pooled proportions of interest. Results are presented with 95% confidence interval. All analyses were done in SAS 9.4®. Results: 9 publications met criteria for this analysis with a total of 196 patients. Bilateral testicular torsions (n = 14) were less common as compared to right/left testicular torsion (n = 85/97). Asynchronous NTTs (n = 9) were more common than synchronous NTTs (n = 2). There was a higher incidence of NTT in neonates delivered by vaginal delivery (n = 110) as compared to those delivered by c-section (n = 25). Extravaginal torsion (n = 54) is far more common than intravaginal torsion (n = 2). Full-term neonates (n = 122) have a higher incidence of NTT as compared to preterm neonates (n = 9). A total of 15 testicles were salvaged. Of the salvaged testicles 2 were documented as prenatal, 10 postnatal and 3 were undocumented. A strategy of bilateral exploration allows for salvage of about 7% of ipsilateral testicles and prevent asynchronous torsion in about 4% of neonates. Conclusions: Based on our population, between 8-12% of patients would benefit from bilateral exploration at the time of diagnosis. We recommend urgent bilateral exploration with orchiopexy of the contralateral testicle in order to avert anorchia. Type of study: Systematic review. Level of evidence: Level 5 meta-synthesis (Evidence from systematic reviews of qualitative and descriptive studies).
MeSH term(s)	Humans ; Infant, Newborn ; Male ; Orchiectomy/methods ; Orchiopexy/methods ; Salvage Therapy/methods ; Spermatic Cord Torsion/etiology ; Spermatic Cord Torsion/surgery ; Testis/surgery
Language	English
Publishing date	2018-08-08
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2018.07.006
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Zs.A 607: Show issues

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Article ; Online: Delaying Urgent Exploration in Neonatal Testicular Torsion May Have Significant Consequences for the Contralateral Testis: A Critical Literature Review.

O'Kelly, Fardod / Chua, Michael / Erlich, Tomer / Patterson, Kenneth / DeCotiis, Keara / Koyle, Martin A

Urology

2020 Volume 153, Page(s) 277–284

Abstract: Objective: To assess the optimal management strategy for boys with neonatal testicular torsion ... of all NTT events were asynchronous with a median time to second torsion of 1 day (Range 1-8 ... torsion, we recommend urgent, safe, surgical intervention with both unilateral and bilateral NTT. ...

Abstract	Objective: To assess the optimal management strategy for boys with neonatal testicular torsion (NTT) in the first 30 days of life, and to stratify outcomes for prenatal, postnatal, unilateral, synchronous, and asynchronous events METHODS: All articles including case reports published between 1946 and 2020 in Embase/Scopus/Medline/Pubmed and Web of Science that had a defined diagnosis of NTT within the first 30 days of life were reviewed. Data and outcomes were analyzed individually, and together as pooled data, using a random effect model. Results: There was a total of 152 studies representing 1336 patients. Outcome data was available on 974 patients (1121 testes). NTT was unilateral in 829 cases, synchronous bilateral in 80 cases, and asynchronous in 66 cases. There were a total of 1107 orchiectomies, and 229 salvage orchiopexies. A total of 2.5% synchronous NTT underwent successful salvage. A total of 95.7% of prenatal unilateral torsions underwent orchiectomy, compared with 92% postnatal torsions. 11.8% of all NTT events were asynchronous with a median time to second torsion of 1 day (Range 1-8). The contralateral orchiectomy rate in this group was 31.8%, with a 40% atrophy rate following orchiopexy. The number needed to treat to avoid bilateral orchiectomy was 1.6, and the number needed to treat to avoid solitary atrophy was 2.6. Conclusion: NTT is an important condition carrying a significant risk for testicular loss and endocrine insufficiency. Given the potential catastrophic risk of asynchronous extravaginal torsion, we recommend urgent, safe, surgical intervention with both unilateral and bilateral NTT.
MeSH term(s)	Humans ; Infant, Newborn ; Male ; Orchiectomy ; Orchiopexy ; Salvage Therapy ; Spermatic Cord Torsion/surgery ; Time-to-Treatment
Language	English
Publishing date	2020-12-26
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2020.10.064
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