Testicular injury in breech delivery: possible implications

In a prospective study of 166 male breech babies, 13 babies delivered by cesarean section did not show damage to the genital area. Of the 134 delivered vaginally, 19 showed injury to buttocks, scrotum, or testis. Ten babies (6.5%) showed damage to testis. On follow-up of three months to four years, the testis became normal to palpation in only 3 babies. In 1 baby, the testis became impalpable, leaving an empty scrotum. The testicular injury is more likely to occur in babies with a birth weight of greater than or equal to 2,500 g and born to primipara. The breech babies delivered vaginally should be examined and followed up for possible damage to testis. To avoid costly investigation and risky exploration, a history of breech delivery should be obtained in all cases presenting as anorchia, undescended testis, delayed sexual maturation, or male infertility.