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P1 NEONATAL TESTICULAR TORSION: A LOST CAUSE?

C. M. John, G. Kooner, D. E. Mathew, S. Ahmad, S. Kenny.Royal Liverpool Children's Hospital, Liverpool, UK

Introduction: Neonatal testicular torsion is a rare occurrence. It was first described by Taylor in 1897. Neonatal testicular torsion is widely accepted as being an antenatal event.

Aims: To determine an incidence (which has never been reported) for this rare condition and to assess the surgical outcome of boys presenting with this condition.

Methods: Retrospective analysis of case notes identified from local clinical coding procedures.

Results: Twenty four babies with proven testicular torsion were identified over a 13-year period. There were 359 091 live births in the catchment area during the study period. When calculating the incidence, we excluded 2 babies who were extra-regional referrals. They were all born at full term except for one baby born at 34 weeks. They had a mean birth weight of 3.71 kg (range 2.18–4.78 kg). The right testicle was affected in 13 babies, the left in 9 babies and there were 2 cases of bilateral torsion. Two babies had no twist in the cord but the testicles were non-viable macroscopically and microscopically. Nine of 15 babies where parity was documented were born to primigravida mothers. 19 babies were born by normal delivery and 5 by caesarean section. 20/24 babies presented within the first 36 hours (range 1–9 days). 12 of 24 testes were non-tender at presentation. 21 babies had primary exploration revealing necrotic testicles and underwent orchidectomies. Histopathological examination confirmed haemorrhagic infarction in all cases. Three babies were treated conservatively and the affected testes had atrophied on follow-up ultrasonography. Doppler ultrasound studies were reported as normal in 2 of 13 babies. 16 babies had contralateral orchidopexy. No testes were salvaged following surgery.

Conclusions: This study has shown the incidence of neonatal testicular torsion to be …

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