Bilateral Testicular Torsion in the Neonatal Period

New insights into perinatal testicular torsion

“…However, bilateral torsion was reported for the first time in 1967 by Papadatos and Moutsouris, but by 1995, 16 cases of bilateral PTT had been reported and more than 45 cases by 2007 [4, 5, 7, 9, 16, 28, 30, 32–35, 37, 42, 43, 45, 49, 50]. Based on compilations of these reports, it was estimated that approximately 10% to 22% of PTT are bilateral [19, 49].…”

Fetal diagnosis of testicular torsion: what shall we tell the parents?

“…These babies were previously born at term either vaginally ( n = 2) or by nonprogressive labor. In all three cases, the initial postnatal US demonstrated a testicle of variable size, heterogeneous appearance with a peripheral echogenic rim, parenchymal echogenicity, and no flow on Doppler, which may be an indicator of a torsion event and testicular nonviability . All three cases were managed conservatively, and on routine follow‐up, the twisted testicle were found atrophic with absence of blood flow on Doppler studies.…”

“…It should be stressed that although postnatal US with Doppler color flow assisted us in the deferential diagnosis of testicular torsion from other scrotal pathology such as inflammation, testicular tumors, or hydroceles, no US findings are specific indicators for this condition. Furthermore, the utilization of this modality may be of limited value because Doppler signals do not provide information regarding the duration of the torsion, nor does it ascertain viability …”

“…8,[18][19][20][21][22] Color flow US studies for prenatal diagnosis of testicular torsion may be of limited value and does not provide information regarding the duration of the torsion, nor does it ascertain viability. 2,8,10,[21][22][23][24] Classical histological findings of postpubertal twisted testes include progressive hypoxic lesions, such as lobular edema and slight blood extravasation up to massive hemorrhagic infarction. 25 Similar changes were found also in the prenatally twisted testes 26 and were demonstrated in one of our cases.…”

Beiderseitige intrauterine Hodentorsion mit Infarzierung

“…Obwohl in jedem Alter möglich, liegen die Inzidenzspitzen in den ersten beiden Lebensjahren sowie im Alter von 13 ± 16 Jahren [24]. Die Torsion beim Neugeborenen wurde erstmals 1877 von Taylor [19,26] beschrieben, sie kann in 0,2 % beide Hoden betreffen [2,4,7,9,12,14,15,20,22,26,30]. Die Drehrichtung der Hodentorsion ist immer von auûen nach innen.…”