Bilateral Testicular Torsion in a Pre-Term Neonate

Ryken, Timothy C.; Turner, Joseph; Haynes, Taylor

doi:10.1016/s0022-5347(17)39879-8

Cited by 32 publications

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“…While there is a theoretical possibility that retention of the infarcted testis may result in some hormonal production, in bilateral testicular torsion it is wise to preserve the least infarcted testicle. Another reason to remove the infarcted testicle is to minimize the chance of aptoposis of the germinal epithelium in the contralateral testicle (5). Many authors adopted the policy of early surgical intervention (5,8,10,11).…”

Section: Discussionmentioning

confidence: 99%

“…Bilateral torsion may be synchronous or asynchronous. The time when the torsion occurred is very difficult to determine; it has been reported to occur antenatally as well postnatally (5). Usually it affects healthy full term newborns, but it has been reported in preterm infants also.…”

Section: Introductionmentioning

confidence: 99%

“…Usually it affects healthy full term newborns, but it has been reported in preterm infants also. Definitive diagnosis is difficult to make without scrotal exploration (4,5). The pediatric urologist or pediatric surgeon is usually consulted in the first few hours of life and is faced with formulating the management plan.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Pogorelić

Jukić

Škrabić

et al. 2017

Acta Med. (Hradec Kralove, Czech Repub.)

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A B ST R AC T Introduction: Testicular torsion is a urological emergency. If not recognized in time, this condition may result in ischaemic injury and loss of testis. Simultaneous bilateral neonatal testicular torsion is extremely rare and is usually misdiagnosed. Case report: We report a case of a male newborn, who presented with bilateral scrotal swelling and redness of the scrotum. Doppler ultrasound supported the diagnosis of bilateral testicular torsion, with an absent blood flow signal on the right side and a weak signal on the left side. Testicular exploration through scrotal incision was performed and bilateral testicular torsion was found. Right testis was grossly gangrenous, and right orchiectomy was performed. Left testicle was dark but showed recovery after detorsion with some bleeding from incised tunica albugenia. Fixation of the left testicle was performed. At six month follow-up, the left testis showed signs of atrophy and hormonal assay showed very low testosterone and elevated LH and FSH, suggesting hypogonadism. Conclusions: Management of neonatal testicular torsion is a matter of controversy. Testicular torsion results into acute ischemia and urgent surgical exploration is the key point of management. Although the possibility of salvaging the involved testicles is usually very low it is hard to justify a passive approach to a bilateral torsion resulting in such a devastating condition as anorchia.K E Y WO R D S testicular torsion; neonatal torsion; newborn; bilateral testicular torsion; simultaneous testicular torsion

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Pogorelić

Jukić

Škrabić

et al. 2017

Acta Med. (Hradec Kralove, Czech Repub.)

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“…In contrast to postnatal torsion, which is marked by tenderness and swelling, neonatal torsion is often asymptomatic. 3 Prenatal torsion is unrelated to gestational age or low birth weight and is extravaginal in the majority of cases. 1 A frequently suggested explanation is that loose attachment of the testicular tunic to the scrotum during the in utero and perinatal period permits free rotation of the testis predisposing to torsion.…”

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confidence: 99%

Testicular Torsion in a Pre-Term Neonate

et al. 1999

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A 33-week-old male infant of appropriate status for gestational age, was born vaginally to a 28-year-old gravida 2, para 2 Latino woman after the onset of premature labor. Birth weight was 1724 gm with Apgar scores of 7 at 1 minute and 8 at 5 minutes. The newborn was alert with spontaneous respirations, but had mild intercostal and subcostal retractions requiring external oxygen support. The rest of the examination was unremarkable except for a discolored firm mass, found within the right hemiscrotum, that did not transilluminate. The left testis was in a descended position but of appropriate size and consistency. A testicular ultrasound (Figure 1) demonstrated an enlarged hypoechoic right testicle, and Doppler flow analysis revealed decreased to absent arterial blood flow. Surgical exploration performed within 6 hours uncovered a torsive necrotic right testis. Orchiectomy and contralateral ochiopexy were performed. THE CASE IN CONTEXTTorsion of the testicle in the prenatal or postnatal period is a relatively rare event. 1 Since it's first description in 1897 by Taylor, 2 nearly 100 Figure 1 The right testicle is larger (13 mm vs 9.6 mm) in diameter and slightly more hypoechoic. RT, right; LT, left; TRANS, transverse section.

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“…[3]. Prenatal dönemde testis torsiyonu genellikle sol tarafta ve nadiren bilateral görülmektedir [4].…”

Section: Introductionunclassified

Ultrasonographic features of prenatal testicular torsion: Case report

Ağaçayak¹,

Aydogdu²

2013

Diclemedj

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Although prenatal testicular torsion (PNTT) is rarely observed, it is an important condition that can cause bilateral vanishing testis. Generally, PNTT cases observed as extravaginal torsion and treatment is emergency surgical op-eration. In this article, 39 week presented a case diagnosed in the prenatal testicular torsion. PNTT diagnosis was confirmed by Doppler ultrasonography and emergency surgery was performed. Extravaginal left testicular torsion gangrene and necrosis of the testis was observed in the operation. Left orchiectomy was performed and intrauter-ine ultrasonographic diagnosis was found to be correct.Key words: Testicular torsion, prenatal diagnosis, features, ultrasonography ÖZETPrenatal testis torsiyonu (PNTT) nadir görülmesine rağ-men, bilateral olması durumunda anorşiye neden olabilen önemli bir durumdur. PNTT'lu vakalar da genellikle ekstravajinal torsiyon görülmekte ve tedavisi acil cerrahi girişimdir. Makalemizde 39. hafta da prenatal testis torsiyonu saptanan bir olgu sunulmuştur. PNTT'nu tanısı Doppler USG ile doğrulandı ve acil ameliyata alındı. Ameliyata sol testiste ekstravaginal torsiyon olduğu, testisin gangrene ve nekrotik olduğu gözlendi. Sol orşiektomi yapılan olguda intrauterin ultrasonografik tanısının doğru olduğu saptandı.Anahtar kelimeler: Testis torsiyonu, prenatal tanı, ultrasonografi GİRİŞErişkinde genellikle intravajinal torsiyon görül-mesine rağmen, kesin nedeni bilinmeyen Prenatal testis torsiyonu (PNTT) da ekstravajinal torsiyon görülmektedir. PNTT'ların %72' si intrauterine dö-nemde ortaya çıkar. Hiperaktif kremaster refleksi ve scrotal duvara tunika vajinalisin yeterli fiksasiyonun olmaması torsiyon nedeni olarak düşünülmektedir. Bu tür hastaların %5-30'da her iki testisinde torsiyonuna etken olarak aynı neden bildirilmiştir [1,2].Bu vakada intrauterin testis torsiyonu tanısı ve cerrahi yaklaşımı tartışılmıştır. OLGU SUNUMU38 yaşında sağlıklı, 4 yaşayanı olan anne 5. gebeliğinin 39. haftasında fetus hareketlerinde azalma nedeniyle hastanemize başvurdu. Rutin takipleri hastanemizde yapılan hastanın 32. hafta kontrolün-de transabdominal ultrason (Voluson 730 PRO GE Medical Systems, Milwaukee, WI, USA) ile normal gelişim gösteren, normal testislere sahip erkek fetus saptandı. 36. haftada yapılan ultrason muayenesinde testislerde bilateral minimal hidrosel, sol testiste minimal büyüme izlendi (Resim 1). 39. haftada başvurduğunda yapılan ultrason incelemesinde sağ testis büyüklüğü normal; sol testiste 12x7 ve 6x3 mm hiperekoik alan izlendi (Resim 2), renkli dopplerde akım izlenmedi. Sağ testiste minimal hidrosel mevcut iken, penis normal izlendi. Olgu Çocuk Cerrahisi ve Çocuk Hastalıklarına konsülte edilerek sezeryan operasyonu planlandı. 3390 gr, 50 cm, 1. ve 5.dk. apkarı sırasıyla 9 ve 10 olan canlı erkek bebek başarılı bir sezeryan operasyonu ile doğumu sağlandı. Kardeşlerinde ürogenital anomali öykü-sü bulunmayan bebeğin çocuk hastalıkları uzmanı tarafından yapılan genital muayenesinde testisler

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Bilateral Testicular Torsion in a Pre-Term Neonate

Cited by 32 publications

References 4 publications

Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Testicular Torsion in a Pre-Term Neonate

Ultrasonographic features of prenatal testicular torsion: Case report

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