Spermatic cord torsion in neonates: role of surgical exploration.

Torsion of the spermatic cord is frequent in neonates suffering from acute scrotal distress. A retrospective study was carried out to determine the vi ability and the outcome of testis treated by surgical exploration. Patients and results, - Surgical exploration of 30 neonates presenting acut e scrotal distress found: 18 torsions of the spermatic cord, six intrascrot al bleedings or hematoma due to delivery trauma, five tunics vaginalis infl ammations and one ischemia without torsion. The torsion occurred in utero i n 16 cases and after birth in two cases. The contralateral uninvolved testi s was fixed to the scrotum in all cases. The torsion was extravaginal in 17 cases and intravaginal in one case. In all cases of prenatal torsion, ther e was total necrosis of the testis. One case of postnatal torsion operated on four hours after the beginning of the torsion was saved. Conclusion. - Although the viability of the torsioned testis is compromised in cases of prenatal torsion, surgical exploration is necessary to confirm diagnosis and to avoid any contralateral torsion because bilateral torsion exists. Only emergency surgical exploration can save a testis that has und ergone post-natal torsion as reported in others series. (C) 2000 Editions s cientifiques et medicales Elsevier SAS.