Prenatal testicular torsion: principles of management

To assess our experience with in utero testicular torsion, we retrospectively studied all newborns presenting in the newborn nursery with a diagnosis of neonatal testicular torsion. A total of 25 consecutive cases of torsion of the spermatic cord in 23 patients was identified and explored on an emergency basis. To our knowledge this represents the largest single institution series and 40% of all of the confirmed cases reported in the literature. No viable testicles were found. We strongly believe that torsion of the testis presenting at birth represents an irreversible intrauterine event best treated in an early elective setting. We suggest an inguinal approach with contralateral orchiopexy in all patients who present with signs and symptoms of prenatal (in utero) testicular torsion.