Bilateral asynchronous perinatal testicular torsion: A case report

Bilateral perinatal testicular torsion (PTT) is an extremely rare condition . A baby boy at the postnatal 28th hour presented with right scrotal erythe ma and swelling, and left hydrocele were detected. There were no systemic s ymptoms. Right hydrocele had been detected during prenatal ultrasonography at the 34th week of gestation. Emergency technetium Tc 99m pertechnetate sc intigraphy showed hypoperfusion in both sides suggesting testicular torsion . The patient underwent surgery immediately. Right necrotic testis was remo ved, left testis was judged as viable, and thus was treated with detorsion. Bilateral PTT in the neonate is a true emergency because of the risk of an orchia. Controversy still exists regarding the treatment of unilateral PTT. Some investigators suggest delayed operation regarding the anesthetic risk imposed on the neonate and the reality that operative salvage of the prena tally torsed testicle is a remote possibility. However, although asynchrono us bilateral PTT is rare, the patient with unilateral PTT is at risk of con tralateral testicular torsion in the waiting period of delayed operation. T herefore, the authors recommend early surgical intervention. J Pediatr Surg 35:1348-1349. Copyright (C) 2000 by W.B. Saunders Company.