title: Testicular torsion in the first year of life--characteristics and treatment outcome.
abstract: OBJECTIVE
  To review the characteristics and treatment outcome of testicular torsion in infants, aged 1 month to 1 year, and compare them with those seen in neonates.
  
  
  METHODS
  The study group included 30 patients aged younger than 1 year who were treated for testicular torsion at a tertiary pediatric medical center between 1993 and 2012. Medical records were retrospectively reviewed for clinical characteristics and treatment outcome. Findings were compared between patients who presented before age 1 month (neonate group, n = 17) or later (infant group, n = 13).
  
  
  RESULTS
  The common clinical presentation in the neonate group was a solid, nontender scrotal mass apparent in 13 of 17 patients (76%). In the infant group, 11 of 13 patients (85%) presented with restlessness and 12 of 13 (92%) with a tender scrotal or inguinal mass. Torsion of an undescended testis was significantly more prevalent in infants, 7 of 13 (54%), than neonates, 1 of 17 (6%; P = .009). Although extravaginal torsion was documented in 5 of 6 neonates (83%), 8 of 9 infants (89%) had an intravaginal torsion (P = .011). Orchiectomy was performed in 14 of 17 neonates (82%) and 6 of 13 infants (46%; P = .056). Of the 29 patients with follow-up data, testicular salvage was documented in 1 of 17 neonates (6%) and 2 of 12 infants (17%), at a minimum follow-up of 5 months (P = .55).
  
  
  CONCLUSIONS
  Testicular torsion in the first year of life is a diverse condition. Although neonatal torsions were predominantly extravaginal, infantile torsions were mostly intravaginal, involving undescendent testes in more than half of the cases. Despite fewer orchiectomies performed on the infant group, testicular salvage rates in both groups were similarly low.
authors.affiliation: Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: roymano78@gmail.com.
authors.forename: Roy
authors.initials: R
authors.lastname: Mano
authors.forename: Pinhas M
authors.initials: PM
authors.lastname: Livne
authors.forename: Amihay
authors.initials: A
authors.lastname: Nevo
authors.forename: Bezalel
authors.initials: B
authors.lastname: Sivan
authors.forename: David
authors.initials: D
authors.lastname: Ben-Meir
mesh_terms: D003456:Cryptorchidism / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009336:Necrosis; D009919:Orchiectomy / Q000379:methods; D012189:Retrospective Studies; D012611:Scrotum / Q000000981:diagnostic imaging / Q000601:surgery; D013086:Spermatic Cord Torsion / Q000000981:diagnostic imaging / Q000601:surgery*; D013737:Testis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography