Perinatal extravaginal torsion of the testis in the first month of life is a salvageable event.
OBJECTIVE
To determine the effectiveness of immediate surgical exploration in salvaging perinatal testicular torsion.


METHODS
A retrospective analysis from 1995 to 2000 of boys younger than 30 days of age with surgically documented extravaginal testicular torsion was conducted. All cases were diagnosed after a normal testicular examination by a neonatologist, and all patients underwent urgent exploration to confirm the exact diagnosis and attempt testicular salvage by detorsion with bilateral orchiopexy. If a nonviable testis was determined intraoperatively, it was removed and contralateral orchiopexy was performed. Success was determined by physical examination at 6 months of follow-up.


RESULTS
Ten patients with 10 affected testes were identified and a total of 4 (40%) were salvaged. All the studied testes were right-sided, and of the 4 salvaged testes, all were palpably normal and equal in size to their mate at the 6-month follow-up examination. Of the 6 removed testes, 1 was potentially viable by permanent pathologic section analysis despite preoperative ultrasonography demonstrating no flow and a negative intraoperative bleed test.


CONCLUSIONS
Boys younger than 30 days old presenting with clinical findings suggestive of extravaginal testicular torsion who are expeditiously explored surgically may have a salvageable event in at least 40% to 50%. These statistics are similar to the salvage rates found with the similar management approach of intravaginal torsion.
Sorensen
Mathew D
MD
Department of Urology, University of Colorado Health Sciences Center, Denver, Colorado 80218, USA.
Galansky
Stanley H
SH
Striegl
Amanda M
AM
Mevorach
Robert
R
Koyle
Martin A
MA
D004630:Emergencies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009919:Orchiectomy; D012189:Retrospective Studies; D013086:Spermatic Cord Torsion / Q000000981:diagnostic imaging / Q000601:surgery*; D013737:Testis / Q000098:blood supply / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014463:Ultrasonography