Torsion of spermatic cord in neonate

Torsion of the spermatic cord in the neonate should no longer be considered a clinical rarity. Effectual diagnosis is totally dependent on prompt detection of an asymptomatic, irreducible scrotal swelling that fails to transilluminate. Immediate surgical exploration is indicated. Detorsion and careful inspection for signs of circulatory return should be undertaken in every case. Frankly necrotic testes should probably be removed, but conservation of testicular tissue is otherwise strongly recommended, even in the borderline cases. After detorsion testis must be firmly fixed in proper position. Prophylactic contralateral orchiopexy appears to be advisable, unless a congenital hydrocele intervenes. Most importantly, to avert the grim prognosis this condition bears, we must continually alert our colleagues responsible for neonatal care to the possibility of torsion of the spermatic cord in the immediate postpartum examination of every newborn male infant.