ANTENATAL TESTICULAR TORSION - ONLY ONE CAUSE OF THE TESTICULAR REGRESSION SYNDROME

It has been suggested that the most likely cause of the Testicular Reg ression Syndrome (TRS) is antenatal torsion of the testis. As testicul ar torsion is twice as common on the left this theory cannot explain t he incidence of right sided or bilateral cases. From a 5-year retrospe ctive surgical and pathological review, we confirmed that the left tes tis was the most commonly affected, that boys with TRS tended to be de livered closer to term, and that frequently both testes were present a t birth, but one or both subsequently vanished. We also found that dir ect trauma can produce histological findings indistinguishable from TR S. Close to term, fetal testes are liable to be intrascrotal and there fore susceptible to direct trauma. As the left testis descends into th e scrotum at an earlier stage than the right, it is therefore at great er risk of injury. Since the findings of TRS can be produced by direct trauma, we suggest that intra-partum trauma may predispose to the TRS .