Abstract

Objective:

To investigate the clinical features and treatment of neonatal testicular torsion (NTT), and to summarize the diagnosis and treatment experience.

Methods: The clinical data of infants with NTT admitted to the pediatric urology, Guangzhou Women and Children Medical Center from Jan 2015 to Jan 2021 was analyzed retrospectively. Emergency ultrasound revealed that the blood flow signal in the testis was significantly reduced or disappeared, and heterogeneous mass echoes in the scrotum.

Results: A total of 17 cases were enrolled in this group, and the median age was 5.2d, ranged from 1~17d; the average weight was 3270g, ranged from 2800~4000g; 11 cases were on the left side, 6 cases were on the right side. The median onset time was 3.8d, ranged from 10h to 15d. First manifestations being reported were scrotal swelling, color change, or mass. All the 17 cases were performed by operation and confirmed to testicular torsion. There were 15 cases of extravaginal torsion, and 2 cases of intravaginal torsion. There were 11 cases of clockwise torsion, and 6 cases of anticlockwise torsion. The average degree of twisted testis was 450.8°(270~720°). The rate of orchiectomy was 88.2%. Over 1 year of followed-up, all cases healed well without bleeding or infection of the scrotal wound, and the contralateral testis remained normal. The 2 cases whose parents refused to remove the testis developed testicular atrophy 6 months later.

Conclusions: NTT is rare in clinic and lacks specificity, with a high rate of testis loss. When the newborns appear scrotal swelling, color change or other abnormalities, testicular torsion can not be ruled out, early surgical exploration is required.

Key words: Neonate；Testicular torsion；Orchiectomy；Surgical exploration