Clinical characteristics and treatment analysis of neonatal testicular torsion.

Abstract

Background: Neonatal testicular torsion is a rare but critical condition that requires prompt diagnosis and treatment. While early surgical intervention may offer some benefit, in many prenatal cases, preventing testicular loss remains challenging, even with timely intervention. Early recognition remains challenging due to subtle clinical presentations in newborns.

Objective: This study aims to analyze the clinical characteristics, diagnostic methods, and treatment outcomes of neonatal testicular torsion, providing a reference for early diagnosis and intervention of the disease.

Methods: A retrospective analysis was conducted on cases of neonatal testicular torsion admitted to Anhui Provincial Children's Hospital from August 2014 to June 2024. Information collected included the infants' age, at diagnosis onset time, clinical manifestations, diagnostic methods, surgical treatment, and postoperative follow-up results.

Results: This study included 21 cases of neonatal testicular torsion. Among them, 1 case involved bilateral testicular torsion, and the remaining 20 cases involved unilateral torsion, with 11 cases on the right side and 9 on the left. The median age at diagnosis of the patients was 1 day (IQR: 1-3), and the median onset time was 24 h (IQR: 10-60). All patients underwent surgical exploration, revealing a median torsion angle of 720 degrees (IQR: 360-720). The average surgery duration was 57.9 min (SD: 25.9). In the case of bilateral testicular torsion, the blood supply was restored after detorsion, and the testicles were preserved. However, in the 20 cases of unilateral torsion, necrotic testicles were removed. Postoperative follow-up over an average period of 31.3 months (SD: 11.5) showed no atrophy in the preserved testicles, with good development of the contralateral testicles and no recurrence of torsion.

Conclusion: Neonatal testicular torsion is rare and urgent, often prenatally occurring with high testicular necrosis risk. Ultrasound is crucial for diagnosing cryptorchid testicular torsion. Clinical uncertainty requires prompt surgical exploration to save the testicle.