Torsion of the testicle in the newborn

Torsion of the testicle in the neonate is uncommon. Only nine cases were seen in a 10-year period at the Izaak Walton Killam Hospital for Sick Children in Halifax, Nova Scotia. The authors describe briefly five of their cases to exemplify the features of and problems associated with this condition. They emphasize that (a) a reddish blue, nontender, scrotal or hemiscrotal swelling in the neonate should be considered as torsion of the testicle until proven otherwise and (b) torsion of the testicle in the neonate is a surgical emergency. If testicular tissue is to be saved urgent scrotal exploration is mandatory. The torsion may occur in utero (as is the usual case), at time of birth or post partum, but the time of occurrence cannot be judged. Finally, the authors discuss some of the controversies in the surgical management of this entity, including the surgical approach and management of the contralateral hemiscrotum.