[Major lesions of the testicles observed in infants born by breech presentation]

Surgical investigations of the scrotom were carried out on six infants born by breech presentation. Three of them exhibited clinically significant oedema of the scrotum with haematic infiltration. In two others a bilateral haematoma of the scrotum and of the distal extremity of the penis was noted. In the remaining infant the scrotum was normal at birth but a few hours later an increase in volume and an induration were noted on one side. During surgery the authors noted an intravaginal torsion of the testicle with necrosis confirmed histologically. In four cases there was infiltration of blood into the testicle and the spermatic cord histological examination showing separation of the seminiferous tubules by an effusion of blood, the vegetative cells and the gonocytes being intact. In the last case the testicles and the spermatic cords were normal. The indications for operation on the scrotum were based on opacity to transillumination. The prognosis varies in relation to the lesions discovered. Atrophy of the testicles follows after six hours in cases of torsion while the evolution appears to be better in cases of haematic infiltrations. Breech presentation leads, in a certain number of cases, to haematic infiltration of the testicles and spermatic cords and seems to be a factor leading to torsion of the testicles. Detailed and repeated examinations of the scrotum are thus indicated after births of this type.