Testicular torsion with contralateral vanishing testis

Area of Science:

• Pediatric Surgery
• Neonatal Urology
• Developmental Biology

Background:

• Antenatal testicular torsion is a rare but serious condition.
• Vanishing testis syndrome results from testicular torsion.
• Testicular remnants are often found in cases of vanishing testis syndrome.

Observation:

• An infant presented with a left hydrocele and nonpalpable right testis.
• Antenatal ultrasound revealed a left hydrocele and a normal right testis.
• Intraoperative findings during left hydrocelectomy showed extravaginal torsion of the spermatic cord with a normal left testis and a right testicular remnant.

Findings:

• The case suggests bilateral antenatal torsion occurred.
• The left hydrocele may have protected the left testis from complete vascular compromise.
• The right testis likely underwent complete torsion, resulting in a testicular remnant.

Implications:

• This case provides evidence supporting the theory that testicular remnants result from antenatal torsion.
• It highlights the potential protective role of hydroceles in preventing complete testicular loss.
• Understanding these mechanisms is crucial for diagnosing and managing testicular abnormalities in neonates.